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02.08.2014

Primary herpes simplex virus, spreading herpes orally - .

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A cross-sectional study of herpes simplex virus types 1 and 2 in college students: occurrence and determinants of infection.
Longitudinal evaluation of herpes simplex virus DNA load during episodes of herpes labialis.
The natural history of recurrent herpes simplex labialis: implications for antiviral therapy. Comparison of Chemicon SimulFluor direct fluorescent antibody staining with cell culture and shell vial direct immunoperoxidase staining for detection of herpes simplex virus and with cytospin direct immunofluorescence staining for detection of varicellazoster virus. Acute herpetic gingivostomatitis in adults: a review of 13 cases, including diagnosis and management.
Treatment of herpes simplex gingivostomatitis with aciclovir in children: a randomised double blind placebo controlled study.
Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer. Single-dose, patient-initiated famciclovir: a randomized, double-blind, placebo-controlled trial for episodic treatment of herpes labialis. Valacyclovir and topical clobetasol gel for the episodic treatment of herpes labialis: a patient-initiated, double-blind, placebo-controlled pilot trial.
Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: a multi-center, randomized, placebo-controlled trial. Acyclovir cream for treatment of herpes simplex labialis: results of two randomized, double-blind, vehicle-controlled, multicenter clinical trials.
Valacyclovir for prevention of recurrent herpes labialis: 2 double-blind, placebo-controlled studies. Herpes simplex virus (HSV) types 1 and 2 cause infections of the skin and mucous membranes and can affect several organs, resulting in a variety of clinical manifestations, some of which can be very serious.
Symptomatic genital herpes is characterized by a burning and itching sensation in the genitals, followed by blistering. Herpetic whitlow is an intensely painful infection of the hand involving 1 or more fingers that typically affects the terminal phalanx.


A wide disparity exists between the public and medical community regarding the significance of herpes infections. The majority of recurrent oral herpes cases are caused by herpes simplex virus type 1 (HSV-1) and the majority of genital herpes cases are caused by HSV-2. The virus travels from the skin during contact to the sensory dorsal root ganglion, where latency is established.
However, if the pattern of the lesions is not specific to HSV, its diagnosis can be made by viral culture, PCR, serology, direct fluorescent antibody testing, or Tzanck test. In women who contract the disease, the cervix is infected 80% to 90% of the time during primary infection. While all three drugs decrease the duration and severity of illness and viral shedding, they have no effect on nonreplicating viruses, nor do they eliminate the virus from the ganglia. Although treatment options exist, respondents in one survey considered contracting herpes as worse than breaking up with a significant other, getting fired from a job, or failing a course in school. The diagnosis of an infection with herpes simplex virus type 1 is usually made by the appearance of the lesions (grouped vesicles or ulcers on an erythematous base) and patient history. Primary infections can range from subclinical to severe, with fever, headache, malaise, anorexia, pain, lymphadenopathy and edema. However, if uncertain, the diagnosis of herpes labialis can be made by viral culture, polymerase chain reaction, serology, direct fluorescent antibody testing, or Tzanck test. Other nonoral herpes simplex virus type 1 infections include herpetic keratitis, herpetic whitlow, herpes gladiatorum, and herpetic sycosis of the beard area. The swab should be sent in special viral transport media directly to the laboratory (or placed on ice if transport will be delayed). The differential diagnosis of nongenital herpes simplex virus infection includes aphthous ulcers, acute paronychia, varicellazoster virus infection, herpangina, herpes gestationis (pemphigoid gestationis), pemphigus vulgaris, and Behcet syndrome. Oral acyclovir suspension is an effective treatment for children with primary herpetic gingivostomatitis. Usatine, MDFigure 2.Primary herpetic gingivostomatitis caused by herpes simplex virus type 1 shown in (A) a four-year-old girl with lower lip ulcers and crusting on the upper lip, and (B) a two-year-old girl with ulcers on the lower lip and tongue.


Oral acyclovir, valacyclovir, and famciclovir are effective in treating acute recurrence of herpes labialis (cold sores). A Tzanck test is difficult to perform correctly without specific training in its use, but it may be done in the office setting by scraping the floor of the herpetic vesicle, staining the specimen, and looking for multinucleated giant cells. Recurrences of herpes labialis may be diminished with daily oral acyclovir or valacyclovir. Usatine, MDIn recurrent herpes labialis, symptoms of tingling, pain, paresthesias, itching, and burning precede the lesions in 60 percent of persons.5 The lesions then appear as clusters of vesicles on the lip or vermilion border (Figure 1).
Topical acyclovir, penciclovir, and docosanol are optional treatments for recurrent herpes labialis, but they are less effective than oral treatment. Nongenital herpes simplex virus type 1 (HSV-1) is a common infection that most often involves the oral mucosa or lips (herpes labialis). The primary oral infection may range from asymptomatic to very painful, leading to poor oral intake and dehydration.
Usatine, MDFigure 3.(A) Ulcers that form after the vesicles break, as shown in an adult women with herpes labialis.
Herpes gladiatorum is often seen in athletes who wrestle, which may put them in close physical contact with an infected person. Herpetic sycosis is a follicular infection with HSV that causes vesiculopapular lesions in the beard area. Usatine, MDFigure 9.Vesicles on a red base of the wrist in a woman with herpes gestationis after the loss of a pregnancy.



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