HSV-1 & -2 Complications and Neonatal Herpes
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Questions and Answers

Which of the following herpesviruses is associated with certain cancers?

  • HHV-6
  • EBV (correct)
  • HHV-7
  • HSV-1

    • What is the primary site of latency for the varicella-zoster virus?

  • Monocytes and lymphocytes
  • T-cells
  • B-cells
  • Sensory neurons in the dorsal root ganglion (correct)

    • What is the mode of transmission of HSV-1 and HSV-2?

  • Fecal-oral transmission
  • Vector-borne transmission
  • Direct skin contact and vertical transmission (correct)
  • Airborne transmission

    • What is the percentage of adults infected with HSV-1?

    <p>&gt;60%</p> Signup and view all the answers

    What is the site of reactivation of the varicella-zoster virus?

    <p>Sensory neurons in the dorsal root ganglion</p> Signup and view all the answers

    Which of the following is a complication of HSV-1 and HSV-2 infection?

    <p>All of the above</p> Signup and view all the answers

    Which of the following immune cells is infected by EBV?

    <p>B-cells</p> Signup and view all the answers

    What is the percentage of genital lesions caused by HSV-1?

    <p>40%</p> Signup and view all the answers

    What is the primary infection of HSV-1 in children?

    <p>Gingivostomatitis</p> Signup and view all the answers

    Which of the following is a trigger for reactivation of HSV-1 and HSV-2?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended procedure for a woman with active genital herpes in labour?

    <p>Perform a caesarean section</p> Signup and view all the answers

    What is a characteristic of Varicella-zoster virus (VZV) infection?

    <p>Lesions are infectious, but scabs are not</p> Signup and view all the answers

    What is a complication of Herpes Simplex Virus 2 (HSV2) infection?

    <p>Encephalitis</p> Signup and view all the answers

    What is a feature of Cytomegalovirus (CMV) infection?

    <p>Prolonged shedding of the virus</p> Signup and view all the answers

    What should a dentist with herpetic whitlow do?

    <p>Stop working until complete healing</p> Signup and view all the answers

    What is a clinical feature of Epstein-Barr virus (EBV) infection?

    <p>Infective mononucleosis</p> Signup and view all the answers

    What is a common complication of HSV-1 and HSV-2 infection?

    <p>Dendritic ulcers</p> Signup and view all the answers

    What is the diagnosis of HSV-1 and HSV-2 based on?

    <p>Molecular testing of cerebrospinal fluid (CSF)</p> Signup and view all the answers

    What is the treatment for HSV-1 and HSV-2 infection?

    <p>Antiviral medication such as acyclovir, valacyclovir, and famcyclovir</p> Signup and view all the answers

    What is a complication of neonatal herpes?

    <p>Seizures and brain lesions</p> Signup and view all the answers

    What is the route of transmission of HSV-1 and HSV-2?

    <p>Through contact with an infected person's saliva or mucous membranes</p> Signup and view all the answers

    What is the significance of a four-fold rise in IgG in the diagnosis of HSV-1 and HSV-2?

    <p>It indicates a previous exposure to the virus</p> Signup and view all the answers

    What is the complication of HSV-1 and HSV-2 infection that is associated with high morbidity and mortality?

    <p>Encephalitis</p> Signup and view all the answers

    What is the timing of treatment for HSV-1 and HSV-2 infection?

    <p>Within 48 hours of symptom onset</p> Signup and view all the answers

    What is the route of transmission of neonatal herpes?

    <p>Vertical transmission from mother to child during delivery</p> Signup and view all the answers

    What is the significance of molecular testing in the diagnosis of HSV-1 and HSV-2?

    <p>It is used to confirm the presence of the virus in cerebrospinal fluid (CSF)</p> Signup and view all the answers

    Study Notes

    Herpes Simplex Virus (HSV-1 & -2)

    • Exposure to UV and sunlight, menstruation, and emotional stress can trigger HSV reactivation
    • HSV-1 is more common than HSV-2, with over 60% of adults infected with HSV-1 and 11-30% with HSV-2

    Complications

    • Dendritic ulcers: refer to an ophthalmologist
    • Encephalitis: infection of the brain parenchyma, high morbidity and mortality
    • Neonatal herpes: high morbidity and mortality, symptoms include skin, eyes, and mouth lesions, CNS disease, and disseminated disease

    Diagnosis

    • Molecular testing: Cerebrospinal fluid (CSF)
    • Serology: serum, check for a four-fold rise in IgG, confirm previous exposure

    Treatment and Prophylaxis

    • Treatment within 48 hours after onset of symptoms: decrease severity and shorten course of disease
    • Antiviral medications: acyclovir, valacyclovir, famcyclovir
    • No vaccine available
    • Infection control: perform caesarean section if possible, dentist with herpetic whitlow should only continue working after complete healing, patients should inform dentist if they have an active herpes labialis infection

    Herpesvirus Summary

    • HHV-1: Herpes simplex virus 1, causes herpes labialis, gingivostomatitis, pharyngitis, encephalitis, conjunctivitis, and herpetic whitlow
    • HHV-2: Herpes simplex virus 2, causes genital herpes, neonatal herpes, encephalitis, and meningo-encephalitis
    • HHV-3: Varicella-zoster virus, causes chickenpox and shingles
    • HHV-4: Epstein-Barr virus, causes infective mononucleosis, oral hairy leukoplakia, and lymphoproliferative disorders and cancers
    • HHV-5: Cytomegalovirus, causes mononucleosis-like syndrome, and is associated with certain cancers
    • HHV-6 and HHV-7: cause Roseola infantum and exanthem subitum, respectively
    • HHV-8: causes Kaposi's sarcoma and primary effusion lymphoma

    Primary Infection, Latency, and Reactivation

    • Primary infection: occurs when the virus first enters the body
    • Latency: the virus remains dormant in the sensory neuron in the dorsal root ganglion
    • Reactivation: the virus reactivates and travels down the peripheral nerve to cause symptoms, often triggered by stress

    HSV-1 & -2

    • Background: HSV-1 is more common than HSV-2, with over 60% of adults infected with HSV-1 and 11-30% with HSV-2
    • Transmission: direct skin contact, vertical transmission, contact with mucosal secretions, and contact through surfaces (rare)
    • Primary infection: gingivostomatitis, pharyngitis, herpetic whitlow, gladiatorum, and genital lesions
    • Reactivation: herpes labialis, recurring genital lesions

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    Description

    This quiz covers the complications of HSV-1 and -2, including dendritic ulcers and encephalitis, as well as the symptoms and effects of neonatal herpes. Test your knowledge on this important medical topic.

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