Herpes simplex virus infections occur equally between the sexes throughout the year.
HSV-1 transmission typically occurs via oral-oral, oral-genital, or genital-genital contact.
HSV-2 lesions largely involve the genital tract, with the virus remaining latent in the sacral nerve root ganglia (S2–S5)
Symptoms & Signs
Both viral subtypes can cause genital and oral–facial infections
The infections caused by the two subtypes are clinically indistinguishable.
Gingivostomatitis and pharyngitis: the most frequent clinical manifestations of primary HSV-1 infection; presents as small, grouped vesicles on an erythematous base, burning and stinging sensation, swollen and tender burning and stinging
Genital: most genital infections are caused by HSV-2; presents with bilateral genital ulcerations and tender lymphadenopathy.
Ocular disease: HSV keratitis presents with vision loss, pain, and discharge; it is a major cause of blindness from corneal scarring and opacity.
Neonatal & Congenital infection: Neonatal HSV can present as excessive tearing, eye pain, conjunctival edema, vesicular lesions of the mouth, palate, tongue, seizures, irritability, fever, multiple organ failure
CNS Disease: Both viruses can cause encephalitis; the temporal lobe is often involved; it presents with
the rapid onset of fever, headache, seizures, focal neurologic signs, and impaired consciousness
Bell’s Palsy: HSV-1 is a cause of Bell palsy (facial nerve paralysis)
Esophagitis & Proctitis: usually presents with dysphagia or odynophagia, fever, retrosternal chest pain
Erythema multiforme: HSV infection is the most common cause of EM; Cutaneous eruptions occur 2 to 7 days after herpes simplex infection
Diagnosis can be made by physical examination; Direct fluorescent antibody slide tests, viral culture, polymerase chain reaction
Early antiviral therapy within 72 hours of symptom onset
Antiviral drugs: Acyclovir, Famciclovir, Valacyclovir
Severe or frequent recurrences: Chronic suppressive therapy with antivirals
Keratitis: The usage of topical corticosteroids may exacerbate the infection
Male circumcision is associated with a lower incidence of acquiring HSV-2 infection.
- What is the most frequent sign of HSV reactivation disease? Herpes labialis
- What is the most frequent etiologic agent of Erythema multiforme? Herpes simplex virus
- What is the most common cause of fatal sporadic encephalitis in the United States? HSV-1 encephalitis
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