Herpes

Which herpes simplex virus serotype is most commonly associated with mouth and lip infections?

HSV-1

Which herpes simplex virus serotype is most commonly associated with genital infections?

HSV-2

Name other body sites HSV-1 can infect.

Eye and sometimes the genital area; it can also infect other sites, especially in immunocompromised patients

What antiviral drugs can be used to treat herpes infections?

Aciclovir and valaciclovir

When is antiviral treatment most effective in herpes simplex infection?

prodromal stage, tingling felt.

Why should herpes cream be dabbed on rather than rubbed?

To reduce spread of viral particles

What hygiene advice helps reduce spread of herpes infection?

Avoid touching sores, kissing, sharing towels or make-up, keep sores clean and dry, use paper towels if possible, and wash hands frequently

What can help reduce sun-triggered recurrence of HSV-1?

wearing sunblock

What symptom-relief medicines can be used in herpes infection?

Ibuprofen or paracetamol for fever and local tenderness

What symptoms can a primary herpes simplex infection cause?

A minority have no symptoms; others may have a minor sore on the tongue or lip, painful blisters and ulcers, pain when eating, swollen neck glands, high temperature, and general aches and pains

How does secondary herpes infection usually differ from a primary infection?

It is usually less severe than a primary infection and tends to recur with reduced frequency over time

What triggers can cause recurrent herpes episodes?

Sunlight, febrile illnesses, and physical or emotional stress

Why can herpes infections become harder to control if the patient manipulates the lesions?

Manipulation can increase the risk of secondary bacterial infection

How long do herpes symptoms normally last?

between 7 to 10 days for cold sores and 2 to 3 weeks for an initial genital herpes infection

What severe CNS infections can Herpes Simplex Virus cause?

Meningitis and encephalitis.

Which HSV type is mainly associated with encephalitis?

HSV-1.

Which HSV type is mainly associated with meningitis?

HSV-2

What are common symptoms of HSV encephalitis?

Flu-like symptoms, confusion, seizures, weakness, and difficulty speaking.

What is meningitis?

Infection of the meninges surrounding the brain and spinal cord.

What are common symptoms of HSV meningitis?

Fever, headache, stiff neck, photophobia, and vomiting.

What is looked for on microscopy in CSF?

Increased white blood cells and red blood cells.

Why are red blood cells counted in CSF?

To check whether symptoms could be due to a subarachnoid haemorrhage.

What does increased neutrophils in CSF suggest?

bacterial infection

What does increased lymphocytes in CSF suggest?

viral infection

What test identifies the cause of viral meningitis?

PCR analysis.

How is HSV CNS infection usually treated?

High-dose parenteral antiviral treatment, usually aciclovir.

How is genital herpes medication usually administered?

oral route

Which oral antiviral medicines can be used for genital herpes?

Aciclovir, famciclovir, and valaciclovir.

What is the risk of transmission at delivery if the baby is delivered vaginally?

About 30–50% if the mother is infected at the time of delivery.

Genital herpes doses

aciclovir 400 mg twice daily, famciclovir 250 mg twice daily, or valaciclovir 500 mg once daily for suppressive treatment

Oral herpes (cold sores) doses

aciclovir 5% cream applied 5 times daily.

What is the usual treatment for suspected neonatal HSV infection?

IV aciclovir