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30.04.2015

Herpe medication and pregnancy, how to cure cold sores on tongue - How to DIY

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HighlightsHerpes VirusesHerpes simplex virus 1 (HSV-1) is the main cause of herpes infections that occur on the mouth and lips.
TransmissionTo infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital area. Unfortunately, only 5% of infected pregnant women have a history of symptoms, so in many cases herpes infection is not suspected, or symptoms are missed, at the time of delivery. Eczema HerpeticumA form of herpes infection called eczema herpeticum, also known as Kaposi's varicellaform eruption, can affect patients with skin disorders and immunocompromised patients.
Herpes in Patients with Compromised Immune SystemsHerpes simplex is particularly devastating when it occurs in immunocompromised patients and, unfortunately, co-infection is common.
Both viruses can be carried in bodily fluids (such as saliva, semen, or fluid in the female genital tract) or in fluid from herpes sores.
If there is evidence of an active outbreak, doctors usually advise a Cesarean section to prevent the baby from contracting the virus in the birth canal during delivery.Approach to the Pregnant Herpes Patient. The risk of infection is highest during outbreak periods when there are visible sores and lesions. Scarring and corneal thinning develop, which may cause the eye's globe to rupture, resulting in blindness.
Centers for Disease Control and Prevention (CDC) recommends that all patients diagnosed with HSV-2 should be tested for HIV.The majority of patients with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. If no lesions are present and cultures indicate no viral shedding, a vaginal delivery can be performed and the newborn is examined and cultured after delivery.Some doctors recommend anti-viral medication for pregnant women who are infected with HSV-2. Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed.GingivostomatitisHerpes can cause multiple painful ulcers on the gums and mucous membranes of the mouth, a condition called gingivostomatitis.
During shedding, the virus can infect other people through exchange of bodily fluids.Sometimes, infected people can transmit the virus and infect other parts of their own bodies (most often the hands, thighs, or buttocks).
Recent studies indicate that acyclovir (Zovirax, generic) valacyclovir (Valtrex), or famciclovir (Famvir) can help reduce the recurrence of genital herpes and the need for Cesarean sections. Untreated, this condition can be extremely serious and possibly fatal.Ocular Herpes and Vision LossHerpetic infections of the eye (ocular herpes) occur in about 50,000 Americans each year. This process, known as autoinoculation, is uncommon, since people generally develop antibodies that protect against this problem.Transmission of Oral Herpes. In most cases, ocular herpes causes inflammation and sores on the lids or outside of the cornea that go away in a few days. HSV is part of a group of other herpes viruses that include human herpes virus 8 (the cause of Kaposi's sarcoma) and varicella- zoster virus (also known as herpes zoster, the virus responsible for shingles and chicken pox).
However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone. HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis and can lead to intellectual disability, cerebral palsy, and death. Herpes can also spread to internal organs, such as the liver and lungs.Infants infected with herpes are treated with acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs.Effects on the Brain and Central Nervous SystemHerpes Encephalitis. Until recently, the general rule was to assume that HSV-1 infections occur in the oral cavity (mouth) and are not sexually transmitted, while HSV-2 attacks the genital area and is sexually transmitted. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. Centers for Disease Control (CDC) recommends that both virologic and serologic tests be used for diagnosing genital herpes.
It is now widely accepted, however, that either type can be found in either area and at other sites.
In addition, because herpes simplex virus 1 can be passed in saliva, people should also avoid sharing toothbrushes or eating utensils with an infected person.Transmission of Genital Herpes.
Patients diagnosed with genital herpes should also be tested for other sexually transmitted diseases.According to the CDC, up to 50% of first-episode cases of genital herpes are now caused by herpes simplex virus 1 (HSV-1). Genital herpes is most often transmitted through sexual activity, and people with multiple sexual partners are at high risk.
However, recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than herpes simplex virus 2 (HSV-2). The virus, however, can also enter through the anus, skin, and other areas.People with active symptoms of genital herpes are at very high risk for transmitting the infection. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates.


It is important for doctors to determine whether the genital herpes infection is caused by HSV-1 or HSV-2, as the type of herpes infection influences prognosis and treatment recommendations.Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 3 days of the outbreak. The virus does not multiply, but both the host cells and the virus survive.At unpredictable times, the virus begins multiplying again. Unfortunately, evidence suggests about a third of all herpes simplex virus 2 (HSV-2) infections occur when the virus is shedding but producing no symptoms. Most people either have no symptoms or don't recognize them when they appear.In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing. Herpes meningitis, an inflammation of the membranes that line the brain and spinal cord, occurs in up to 10% of cases of primary genital HSV-2.
Unfortunately, a third to half of the times shedding occurs without any symptoms at all.Eventually, the symptoms return in most cases, causing a new outbreak of blisters and sores.
At these stages the virus may not be active enough to reproduce sufficiently to produce a visible culture.Polymerase chain reaction (PCR) tests are much more accurate than viral cultures, and the CDC recommends this test for detecting herpes in spinal fluid when diagnosing herpes encephalitis (see below).
This close-up view of early herpes outbreak shows small, grouped blisters (vesicles) and lots of inflammation (erythema). In fact, studies indicate that 10 - 25% of people infected with HSV-2 are unaware that they have genital herpes. Fortunately, after lasting for up to a week, herpes meningitis usually resolves without complications, although recurrences have been reported.
PCR is much more expensive than viral cultures and is not FDA-approved for testing genital specimens. Even if infected people have mild or no symptoms, they can still transmit the herpes virus.Symptoms of Genital HerpesPrimary Genital Herpes Outbreak. However, because PCR is highly accurate, many labs have used it for herpes testing.An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions. The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies). The first signs are a tingling sensation in the affected areas (such as genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters.
The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC.Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either herpes virus simplex 1 (HSV-1) or herpes virus simplex 2 (HSV-2). When the herpes virus infects someone, their body’s immune system produces specific antibodies to fight off the infection. The lesions may sometimes itch, but itching decreases as they heal.About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, fever, and swollen glands. If a blood test detects antibodies to herpes, it’s evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The CDC recommends only type-specific glycoprotein (gG) tests for herpes diagnosis.Serologic tests are most accurate when performed 12 - 16 weeks after exposure to the virus.
Women may have only minor itching, and the symptoms may be even milder in men.On average, people have about four recurrences during the first year, although this varies widely.
There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 causes genital herpes. HSV-2 genital infection is more likely to cause recurrences than HSV-1.Symptoms of Oral HerpesOral herpes (herpes labialis) is most often caused by herpes simplex virus 1 (HSV-1) but can also be caused by herpes simplex virus 2 (HSV-2). It usually affects the lips and, in some primary attacks, the mucous membranes in the mouth.
Its major advantages are that it requires only a finger prick and results are provided in less than 10 minutes.
A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon.Primary Oral Herpes Infection. In adolescents, the primary infection is more apt to appear in the upper part of the throat and cause soreness.Recurrent Oral Herpes Infection. It is costly and time consuming, however, and is not as widely available as the other tests.False-negative (testing negative when herpes infection is actually present) results can occur if tests are done in the early stages of infection. False-positive results (testing positive when herpes infection is not actually present) can also occur, although less often than false-negative.
Recurrences are usually much milder than primary infections and are known commonly as cold sores or fever blisters (because they may arise during a bout of cold or flu).
The polymerase chain reaction (PCR) assay of cerebrospinal fluid detects tiny amounts of DNA from the virus, and then replicates them millions of times until the virus is detectable. PCR identifies HSV in cerebrospinal fluid and gives a rapid diagnosis of herpes encephalitis in most cases, eliminating the need for biopsies. The CDC recommends PCR for diagnosing herpes central nervous system infections.Imaging Tests.


Brain biopsy is the most reliable method of diagnosing herpes encephalitis, but it is also the most invasive and is generally performed only if the diagnosis is uncertain.
With the increased use of PCR, biopsies for herpes are now only rarely performed.Similar ConditionsCanker Sores (Aphthous Ulcers).
Simple canker sores (known medically as aphthous ulcers) are often confused with the cold sores of herpes simplex virus 1 (HSV-1).
Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. Occasionally, the symptoms may not resemble those of the primary episode but appear as fissures and scrapes in the skin or as general inflammation around the affected area.Triggers of Recurrence. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress.
Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction.Timing of Recurrences. In most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time. However, the immune system cannot kill the virus completely.Risk FactorsRisk for Oral HerpesOral herpes is usually caused by HSV-1. Centers for Disease Control and Prevention, about 1 in 6 American teenagers and adults, are infected with HSV-2. While HSV-2 remains the main cause of genital herpes, in recent years HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men.
This group is at higher than average risk for herpetic whitlow, herpes that occurs in the fingers.Wrestlers, rugby players, and other athletes who participate in direct contact sports without protective clothing. These individuals are at risk for herpes gladiatorum, an unusual form of HSV-1 that is spread by skin contact with exposed herpes sores and usually affects the head or eyes.Preventing TransmissionInfected people should take steps to avoid transmitting genital herpes to others. It is almost impossible to defend against the transmission of oral herpes since it can be transmitted by very casual contact.Genital herpes is contagious from the first signs of tingling and burning (prodrome) until the time that sores have completely healed. Natural condoms made from animal skin do NOT protect against HSV infection because herpes viruses can pass through them.Use a water-based lubricant.
Lubricants can help prevent friction during sex, which can irritate the skin and increase the risk for outbreaks.
Only water-based lubricants (such as K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used.
Oil-based lubricants (such as petroleum jelly, body lotions, and cooking oil) can weaken latex. However, it is best not to use condoms pre-lubricated with spermicides.Do not use spermicides for protection against herpes. If you do, be sure to immediately wash your hands with hot water and soap.The herpes virus does not live very long outside the body. While the chances of transmitting or contracting herpes from a toilet seat or towel are extremely low, it is advisable to wipe off toilet seats and not to share damp towels.Recent studies have suggested that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections.
Herpes in newborn babies (herpes neonatalis) can be a very serious condition.Fortunately, neonatal herpes is rare.
Although about 25 - 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy. This increased risk is present if the woman is having or has recently had an active herpes outbreak in the genital area.Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes.
Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Infants may get congenital herpes from a mother with an active herpes infection at the time of birth. Aggressive treatment with antiviral medication is required, but it may not help systemic herpes.



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