Herpes Simplex Fact : Neonatal HSV Infection

 Neonatal infection can be divided into 3 clinical types, namely: the spread of infection and generally attacks the liver, encephalitis and infections limited to skin, eyes and mouth. The first and second form often leads to death. Infections are usually caused by HSV 2 but infections caused by HSV1 is also common. The risk of infection in children depends on 2 main factors in the mother; the pad when the gestational age of pregnant women is generating HSV and depends also on whether the infection suffered by secondary infection or primary infection.
Only HSV excretion containing incurred during childbirth are dangerous for newborns with intrauterine infection although rare exceptions may occur. Primary infection in the mother can increase the risk of infection in infants from 3% to 30%, presumably because of immunity in the mother can provide protection.

Herpes Simplex Fact

Herpes simplex is a viral infection characterized by localized primary lesion, latency and the tendency for recurrence. There are 2 types of virus - the herpes simplex virus (HSV) types 1 and 2 in general lead to different clinical symptoms, depending on the entry road. Can attack the means of genital or oral mucosa. Primary infection with HSV-1 may be mild with no symptoms, occurred in early childhood.
Approximately 10% of primary infection, emerged as a disease with a diverse spectrum of clinical symptoms, characterized by hot and malaise to 1 week or more, may be accompanied by severe gingivostomatitis followed by a vesicular lesions on the oropharynx, severe keratoconjunctivitis, and accompanied by the emergence of symptoms and complications of chronic eczema-like skin, meningoencephalitis or some fatal infection that occurs in newborns (congenital herpes simplex, ICD-9 771.2, ICD-10 P35.2).

Herpes Zoster (shingles)

Herpes zoster (shingles) is a local manifestation of reactivation of latent varicella infection in the dorsal ganglia radix. Vesicular lesions appear as erythema limited basis in areas of skin, which follows the course of a single sensory nerve ganglia or group radix dorsalis. The lesions can appear in the form of an irregular bubble gang during the course of the nerve, usually unilateral. Vesicles located deeper and gather more closely than chicken pox, herpes zoster and varicella are histologically similar to each other. Almost always accompanied by pain and paresthesias once, and about 30% of adults who fell ill suffered from postherpetic neuralgia herpes. 

Herpes Simplex Encephalitis Complications and Prognosis

HSE  Complications
Seizures are common and some authors recommend prophylactic anti-seizure therapy in patients with severe HSE. Brain edema that occurs sometimes can be resolved with steroid therapy, although the use of steroids in the HSE is still a controversy. Adjunct therapy for brain edema include hyperventilation and barbiturates. Other complications that looks similar to all patients and patients with severe pain severe consciousness disturbance (eg, aspiration pneumonia, venous thrombosis profundus, and decubitus.)  

HSE  Prognosis

Herpes Simplex Encephalitis Therapy

Management of HSE
The aim of treatment is to shorten the clinical course of disease, prevent complications and prevent the development of disease recurrence. Drug of choice is acyclovir, which is an antiviral substances that selectively inhibit replication of the virus without damaging normal cells by holding a competition with guanoside for viral DNA polymerase. Acyclovir is said to have the effect of minimum follow-up. The drug is excreted through the kidneys and the dosage should be reduced in patients with renal dysfunction.

Radiological HSE Examination

HSE Radiological examination

MRI is an examination of selected, able to show pathologic changes are usually bilateral, in the medial temporal lobe and the inferior frontal lobe. The existence of lesions in the temporal lobe is significant HSE in the allegation.

Head CT scans can show changes in the temporal and frontal lobes, but less sensitive than MRI. In a third patient HSE found a normal head CT scan.
Other Examination

Herpes Simplex Encephalitis: Lab Examination

Laboratory Examination for Herpes Simplex Encephalitis
CSS Analysis: Typically shows mononuclear pleocytosis with a mild increase in protein levels while the glucose levels normal or decreased slightly. In the early phases of disease, sometimes cell count may be normal, although on serial examination always found an increasing number of cells and proteins. If there is bleeding in the brain parenchyma, the number of erythrocytes is always increasing and the increase was settled on the all tube inspection. HSV CSF culture is rarely found in patients with HSE.

Herpes Simplex Encephalitis Clinical manifestations

Clinical manifestations HSE

HSE is acute or subacute with focal and general signs of cerebral dysfunction. Are sporadic and not associated with the pattern of a particular season. Although fever, headache, behavioral changes, confusion, focal neurological abnormalities and abnormalities in CSF supports the HSE, there are no clinical signs patognomonis to distinguish HSE from other neurological diseases (eg non-HSV encephalitis, brain abscess or brain tumor). Confirmation of the diagnosis depends on identification of HSV from CSF examination by PCR or in brain tissue with brain biopsy.

Genital Herpes Simplex

Genital herpes simplex is an acute infection (STD = sexually transmitted disease), caused by Herpes Simplex Virus (HSV = Herpes Simplex especially virus type II), characterized by the onset of vesicles (vesicle = elevation of the skin firmly bounded by less than 1 cm in diameter and can be rupture causing erosion as small sores) on the mucosa surface of the skin (mukocutaneus), clustered on the basis of reddish skin. In general, occur in parts of the body below the navel, especially the genital area and surrounding areas. The most common cause is HSV genital Herpes simplex type II.

Herpes Virus Simplex Type 1 and Type 2

The type 1 and type 2 herpes simplex viruses can cause severe genital infection. When someone first gets genital herpes, it is impossible to tell from the signs and symptoms whether the infection is due to the type 1 or the type 2 virus. There is, however, a marked difference in the incidence and frequency of recurrent genital infections caused by these two viruses. The type 1 virus is sometimes viewed as the better of the two, because many people with primary genital type 1 infection never have recurrent infections, and those who do generally have only occasional outbreaks.

The Herpes Virus

The word “herpes” means different things to different people. To some, herpes is the name given to the troubling blisters or sores that can periodically appear on or around the lips. To others, herpes is a feared sexually transmitted disease that can be caught once but which has a painful aftermath that can be reexperienced many times.