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18.02.2014

Diagnosis herpes simplex virus, genital herpes causes - Plans Download

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Clinical Presentation of Herpes Simplex Virus HSVAbout 50% of people with Herpes Simplex Virus (HSV) may not have any symptoms at all but they can still spread the virus to their partners.First episode of genital herpes can be divided into primary herpes and non-primary herpes infection. Treatment of Herpes Simplex VirusGeneral measures include cleaning the affected areas with normal saline and usage of oral or topical analgesics to control pain. Genital Herpes Simplex Virus in pregnancyTransmission of herpes to the neonates occurs when mother has symptomatic genital herpes during delivery. Follow up post herpes infectionPatients with herpes simplex virus should be educated on the disease, its transmission, treatment and also potential of recurrence. Human herpes simplex virus (HSV) infection in neonates can result in devastating outcomes, including mortality and significant morbidity.
Primary herpes refer to the group of people with no prior exposure to either Herpes Simplex Virus Type 1 or Type 2. The risk of transmission to neonate is higher (30-50%) from a mother with primary genital herpes during pregnancy as compared to mothers who have recurrent herpes or virus shedding during phase without symptoms. Neonatal herpes simplex virus infections in Canada: Results of a 3-year national prospective study.
A person with herpes may spread the herpes virus to the partner even when they do not have symptom, this is known as asymptomatic shedding of virus. Non-primary genital herpes refer to people who have their first episode of genital herpes however they have herpes simplex virus type1 or 2 infections at other body sites before.First episode of genital herpes is often severe, painful multiple grouped vesicles which will rupture into erosions and ulcer will occur over the genitalia area. These drugs are useful to aid recovery of each herpes episodes however they do not eradicate the virus from the person.
Women who are pregnant should inform their obstetricians early.Sexual partners of patients with herpes should be counseled together with their partners. It considers diagnosis and prognosis according to infection category, along with testing modalities and limitations. Effect of serologic status and Cesarean delivery on transmission rates of herpes simplex virus from mother to infant. Type 1 and 2 Herpes Simplex virus have type specific glycoproteins gG1 in HSV1 and gG2 in HSV2 which can be tested individually allowing typing of HSV. Specific therapy with antiviral medications may not always be necessary.For each episode of recurrence genital herpes, if antiviral treatment is necessary it should be started within 1 day of the attack. These tests are useful for diagnosis, screening of partners and detection of unrecognized infections.


Starting 6 weeks from delivery, weekly genital viral cultures are taken and tested for herpes. If positive, treatment is commenced.If genital herpes lesions are present at labor, prepare for caesarean section within 6 hours from membrane rupture. If recur then continue suppression therapy.Treatment regime for HIV patients with Herpes Simplex VirusHIV patients being immune-compromised are prone to herpes recurrence.
Immunosuppression states like patients with diabetes, renal patients, HIV patients and patients on immunosuppressant drugs like steroid are more susceptible to recurrence of herpes.
If any of the culture is positive, treatment should be started immediately and baby should be closely monitored.If there are no genital herpes lesions present at labor, mother can proceed with vaginal delivery. Regional distribution of antibodies to herpes simplex virus type 1 (HSV-1) and HSV-2 in men and women in Ontario, Canada. Antenatal seroprevalence of herpes simplex virus type 2 (HSV-2) in Canadian women: HSV-2 prevalence increases throughout the reproductive years. Newborns with intrauterine infection present at birth or shortly thereafter.The absence of skin lesions does not negate the possibility of an NHSV diagnosis.
However, a normal initial CSF examination does not necessarily exclude the diagnosis of an NHSV CNS infection.[26]Infants who present with disseminated disease are less likely to survive than infants with SEM or CNS disease. When skin lesions are present, rapid diagnostic techniques, such as direct immunofluorescence of virus-infected cells for the presence of HSV antigens, are of value.
Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection. Therefore, the CSF DNA PCR test should be performed even when these parameters are normal.The evaluation of HSV viremia using DNA PCR is less well established than CSF DNA PCR testing.
A poorer prognosis has also been associated with persistence of HSV DNA in the CSF of patients on acyclovir.[35]Infant serology is not useful for diagnosing NHSV for three main reasons. Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Neonatal herpes simplex meningoencephalitis associated with fetal monitor scalp electrodes. Herpes simplex virus infection after vacuum-assisted vaginally delivered infants of asymptomatic mothers. Herpes simplex virus infection in young infants during 2 decades of empiric acyclovir therapy.


Human antibodies to herpes simplex virus type 1 glycoprotein C are neutralizing and target the heparan sulfate-binding domain. Neonatal herpes simplex: Clinical findings and outcome in relation to type of maternal infection. Safety and efficacy of high-dose acyclovir in the management of neonatal herpes simplex virus infections. Predictors of morbidity and mortality in neonates with herpes simplex infections: The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Clinicians should speak with a laboratory specialist or infectious diseases consultant when neonatal herpes simplex virus (NHSV) is suspected and laboratory tests are being requested. Infants admitted with pneumonia of uncertain etiology who do not improve after 24 h on antibiotics, especially if the radiographic picture is consistent with viral pneumonia. Detection of viral DNA in neonatal herpes simplex virus infections: Frequent and prolonged presence in serum and cerebrospinal fluid.
Multiplex real-time PCR for the simultaneous detection of herpes simplex virus, human herpesvirus 6, and human herpesvirus 7. Quantitation of viral load in neonatal herpes simplex virus infection and comparison between type 1 and type 2.
Time course of seroconversion by HerpeSelect ELISA after acquisition of genital herpes simplex virus type 1 (HSV-1) or HSV-2. Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Mothers with herpes labialis should wear a disposable mask when caring for their infant <6 weeks of age, until lesions are crusted. There is no contraindication to breastfeeding unless there are herpetic lesions on the breast.



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