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Herpetic infection(herpes simplex) is a group of diseases caused by the herpes simplex virus, which are characterized by damage to the skin, mucous membranes, central nervous system, and sometimes other organs.
Herpetic infection. Common form
Etiology. The pathogen belongs to the herpes family. This family also includes the viruses of chickenpox, herpes zoster, cytomegaloviruses, the causative agent of infectious mononucleosis, etc. Based on their antigenic structure, herpes simplex viruses are divided into two types. The genomes of type 1 and type 2 viruses are 50% homologous. Type 1 virus primarily causes damage to the respiratory organs. Herpes simplex virus type 2 is associated with the occurrence of genital herpes and generalized infection of newborns.
Epidemiology. The source of infection is humans. The pathogen is transmitted by airborne droplets through contact, and the genital pathogen is transmitted through sexual contact. With congenital infection, transplacental transmission of the virus is possible. Herpes infection is widespread. Antibodies to the herpes simplex virus are detected in 80-90% of adults.
Pathogenesis. The portal of infection is the skin or mucous membranes. After infection, virus replication begins in the cells of the epidermis and the skin itself. Regardless of the presence of local clinical manifestations of the disease, virus replication occurs in a volume sufficient to introduce the pathogen into sensory or autonomic nerve endings. The virus or its nucleocapsid is thought to spread along the axon to the nerve cell body in the ganglion. The time required for infection to spread from the hilum to the ganglia in humans is unknown. During the first phase of the infectious process, pathogens multiply in the ganglion and surrounding tissues. Then, along the efferent pathways represented by peripheral sensory nerve endings, the active virus migrates, leading to disseminated skin infection. The spread of pathogens to the skin along peripheral sensory nerves explains the extensive involvement of new surfaces and the high frequency of new lesions located at a considerable distance from the sites of primary localization of the vesicles. This phenomenon is typical both for individuals with primary genital herpes and for patients with oral-labial herpes. In such patients, the virus can be isolated from nervous tissue located far from the neurons innervating the site of entry of the pathogen. Its penetration into surrounding tissues causes the spread of the virus through the mucous membranes.
After the completion of the primary disease, neither active virus nor surface viral proteins can be isolated from the nerve ganglion. The mechanism of latent viral infection, as well as the mechanisms underlying the reactivation of herpes simplex virus, are unknown. Reactivation factors include ultraviolet radiation, skin or ganglion trauma, and immunosuppression. When studying strains of the herpes virus isolated from a patient from different lesions, their identity was established. However, in people with immunodeficiencies, strains isolated from different places differ significantly, which indicates the role of additional infection (superinfection). Both cellular and humoral factors play a role in the formation of immunity against the herpes virus. In patients with weakened immunity, latent infection becomes manifest, and manifest forms are much more severe than in individuals with normal immune system activity.
Symptoms and course. The incubation period lasts from 2 to 12 days (usually 4 days). Primary infection often occurs subclinically (primary latent form). In 10-20% of patients, various clinical manifestations are noted. The following clinical forms of herpetic infection can be distinguished: skin lesions (localized and widespread); lesions of the mucous membranes of the oral cavity; acute respiratory diseases; eye lesions (superficial and deep); encephalitis and meningoencephalitis; visceral forms (pneumonia, esophagitis, hepatitis, etc.); generalized herpes; genital herpes; herpes of newborns; herpes in HIV-infected people.
Herpetic skin lesions. Localized herpes infection usually accompanies some other disease (acute respiratory disease, pneumonia, meningococcal infection, etc.). Herpetic infection develops in the midst of the underlying disease or already during the recovery period. General symptoms are absent or masked by manifestations of the underlying disease. Herpetic rash is usually localized around the mouth, on the lips, on the wings of the nose (herpes labialis, herpes nasalis). At the site of the rash, patients feel heat, burning, tension or itching of the skin. On moderately infiltrated skin, a group of small bubbles appears filled with transparent contents. The bubbles are closely spaced and sometimes merge into a continuous multi-chamber element. The contents of the bubbles are initially transparent, then become cloudy. The bubbles subsequently open, forming small erosions, or dry out and turn into crusts. A secondary bacterial infection may develop. In case of relapses, herpes usually affects the same areas of the skin.
Herpes simplex
Herpetic lesions of the mucous membranes of the oral cavity manifest themselves in the form of acute herpetic stomatitis or recurrent aphthous stomatitis. Acute stomatitis is characterized by fever and symptoms of general intoxication. Groups of small bubbles appear on the mucous membranes of the cheeks, palate, and gums. Patients complain of burning and tingling in the affected area. The contents of the bubbles are initially transparent, then become cloudy. In place of the burst bubbles, surface erosions form. After 1-2 weeks. mucous membranes are normalized. The disease may recur. With aphthous stomatitis, the general condition of the patients is not impaired. Single large aphthae (up to 1 cm in diameter), covered with a yellowish coating, form on the mucous membranes of the oral cavity.
Herpetic infection. Damage to lips and tongue
Acute respiratory diseases. Herpes simplex viruses can cause inflammation of the mucous membranes of the upper respiratory tract. From 5 to 7% of all acute respiratory infections are caused by herpes infection. Herpetic lesions of the pharynx manifest themselves in the form of exudative or ulcerative changes in the posterior wall of the pharynx, and sometimes in the tonsils. In many patients (about 30%), the tongue, buccal mucosa, and gums may also be affected. However, most often, based on clinical manifestations, herpetic acute respiratory infections are difficult to distinguish from those of other etiologies.
Diagnosis. Recognition of herpetic infection in typical cases is based on characteristic clinical symptoms, i.e., when there is a characteristic herpetic rash (a group of small blisters against the background of infiltrated skin). To confirm the diagnosis, virus isolation (detection) methods are used. The material for its isolation from a sick person can be the contents of herpetic vesicles, as well as saliva, scrapings from the cornea, fluid from the anterior chamber of the eye, blood, cerebrospinal fluid, pieces of a biopsied cervix, cervical secretion; During the autopsy, pieces of the brain and various organs are taken. For diagnostic purposes, the contents of herpetic vesicles are examined by immunofluorescence to detect viral antigens or by polymerase chain reaction (PCR) to detect herpesvirus DNA. Serological reactions have little information content. The presence of positive results without a dynamic increase in antibody titers can be detected in many healthy people (due to latent herpetic infection). However, an increase in antibody titer by 4 times or more is detected only in acute infection (primary), and in case of relapse - only in 5% of patients.
Treatment. Herpes infection in all clinical forms is susceptible to antiviral drugs. The most effective of them is acyclovir. In immunocompromised patients with acute first or repeated episodes of damage to the skin and/or mucous membranes, the drug is administered intravenously at a dose of 5 mg/kg every 8 hours or orally 200 mg 5 times a day for 7-10 days. For local external lesions, applications of acyclovir in the form of a 5% ointment 4-6 times a day can be effective. To prevent viral reactivation: acyclovir intravenously at a dose of 5 mg/kg every 8 hours or orally 400 mg 4-5 times a day - prevents relapses of the disease during a period of increased risk (for example, in the immediate post-transplant period). In patients with normal immunity, the effectiveness of oral use of acyclovir in the first episode has not been studied, and in case of relapses it is not recommended (local use of the drug has no clinical significance).
Prevention and measures in the outbreak. To prevent airborne spread of infection, a set of measures should be carried out as in case of acute respiratory infections. Precautions must be taken to prevent infection in newborns. A killed vaccine is being developed to prevent relapses of herpes infection. Its effectiveness has not yet been sufficiently studied.
"Diseases, injuries and tumors of the maxillofacial area"
edited by A.K. Iordanishvili
Herpes infection is a pathological process characterized by a chronic but recurrent course. The skin and nerve cells are most often affected. The disease can occur in both adults and children.
The causative agent of the disease is the herpes virus, which can enter the human body in several ways. The most common mechanism of infection is considered to be contact.
The pathology has specific external symptoms that cannot be ignored. This includes the expression of a characteristic rash, often looking like bubbles filled with cloudy liquid. In some cases, there is an asymptomatic course.
Diagnosis is based on information obtained during a physical examination, as well as the results of laboratory blood tests. Instrumental procedures are not used.
Treatment of herpetic infection is carried out using conservative methods, including the use of medications and physiotherapeutic procedures.
Today, two types of herpes simplex virus are known, which act as a provocateur of the disease. Each type has its own characteristics.
The first type of virus is characterized by:
The pathogen of the second type in all cases provokes the formation. It follows from this that infection most often occurs through unprotected sexual contact. In addition, there is a high risk of vertical infection - in this case, the virus affects the child either during intrauterine development, that is, transplacentally or directly during labor.
It is worth noting that this variant of the course of the disease is several times less common than the infectious process caused by the herpes simplex virus type 1.
The reservoir and source of herpesvirus infection is a sick person or a carrier of the virus who has an asymptomatic course of the pathological process.
The danger of the disease provocateur is that it can maintain its vital activity for a long time in nerve cells, which are also called ganglia. This is what causes frequent relapse of the disease under the influence of unfavorable factors that weaken the immune defense of the human body.
It is also worth noting that infection with one type of herpes simplex virus does not exclude the possibility of infection with another variety or their serotypes, which include:
Also distinguish 6, 7 and 8 subtypes, which are involved in the occurrence of chronic fatigue syndrome, multiple sclerosis, or lead to the appearance of a sudden rash.
It is noteworthy that almost every person is infected with the herpes simplex virus. After the initial infection, the source of the disease remains in the body forever. Exacerbation can be caused by:
HSV infection is usually classified depending on the location of the pathological focus. Thus there is:
Clinicians distinguish two options for the course of the disease:
Depending on the clinical form, herpes infection is divided into:
In addition, there are several degrees of severity of such a disease:
Persistent herpes infection is a primary infection that does not have an incubation period and is characterized by the fact that it occurs without expressing any symptoms.
Since a herpes viral infection is formed due to the influence of a pathological agent, it is worth mentioning the incubation period, which lasts from 2 to 12 days, but is often one week. It is advisable to classify this as a recurrent chronic variant of the disease.
Clinical manifestations will differ depending on which tissues are involved in the pathological process. Skin lesions are characterized by the following symptoms:
Symptoms of herpetic infection in adults and children when the lesion is localized on the oral mucosa:
Genital herpes often manifests itself:
Symptoms of ophthalmoherpes are presented:
In children and patients with a weakened immune system, a generalized form of herpetic infection occurs, which is characterized by:
Given that herpes infection has several course options, depending on the affected tissues, when the first symptoms occur, you should seek help from:
Due to the fact that the disease has pronounced and quite specific clinical manifestations, establishing the correct diagnosis does not cause any particular difficulties.
First of all, the clinician needs to:
Laboratory diagnostics involves the implementation of:
Additional instrumental examinations of the patient may be necessary only in cases of generalized herpes viral infection.
Elimination of the disease is carried out only by conservative methods. Treatment of chronic herpes involves the use of the following medications:
To obtain a positive effect, it is best to use an integrated approach to treatment, which involves the following physiotherapeutic procedures:
In addition, therapy should also include:
Treatment with folk remedies should not be the only method of therapy and is never carried out without prior consultation with the attending physician.
and esophagitis. dysfunction of the adrenal cortex. Prevention and prognosis
To reduce the likelihood of recurrence of herpes infection, you must adhere to the following general recommendations:
- lead a healthy and moderately active lifestyle;
- avoid hypothermia, physical and emotional fatigue;
- eat properly and nutritiously;
- constantly strengthen the immune system;
- use barrier methods of contraception during sexual intercourse;
- undergo a full medical examination several times a year.
The prognosis for herpes viral infection is often favorable, but only if you seek qualified help.
The most common unfavorable outcome is damage to the central nervous system, visual organs and genitals. The disease is most dangerous for people with immunodeficiencies, children and pregnant women.
The development of some complications can cause the death of the patient.
23.10.2015
Herpetic infection(synonym: herpes simplex) is the collective name for infections caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
The development of herpetic disease in humans is always associated with the presence of a fairly severe immunodeficiency state, and the stronger the immune disorders, the greater the severity of the disease.
Term "herpes"(from the Greek herpes, creeping) was used by Herodotus in 100 BC to describe blisters accompanied by fever.
According to epidemiologists, women around the world underestimate the danger of herpes infections, while complications from herpes in women are much more common than in men.
. First type- Herpes Labialis (labial form of herpes), HSV-1, which affects the face, nasolabial triangle, oral cavity, nasal cavity, and sometimes cheeks.
The most common disease is “fever” (“cold on the lips”), which, although it is a disease of the body as a whole, gives external manifestations on the nasolabial triangle (on the lips and on the wings of the nose).
It was described by Hippocrates; it has been a known disease for a very long time. And all of humanity is most often susceptible to it (about 20%).
. Second type(genital herpes) is the second type of herpes simplex virus, HSV-2.
It should be noted that in the era of the sexual revolution, when almost every married couple uses oral sex and urogenital contacts, according to the latest Japanese data, the statistics are as follows.
Up to 47% of cases (read up to 50) genital herpes is caused by oral sex by the first type of virus. True, in the first type the recurrence rate is quite low, and more than three times a year is already considered a lot.
As for the second type, this is usually once every two to three months, or even twice a month. The intensity of spread, in particular, of genital herpes increases significantly over time.
There are figures that if in 1980 16 percent of the approximately US population had genital herpes, then in 2002 this figure is estimated to be 24 percent, which is about 60 million people.
And the clinical manifestations of genital herpes are very active, and this causes great concern both among the affected people and among medical workers, who are by no means sufficiently armed with the means to combat this widespread and, in general, extremely serious disease.
Ophthalmoherpes- This is a fairly common disease. It is called by both the first type and the second, but it is not Zoster.
. Third type- (herpes zoster), official name: chickenpox virus - herpes zoster or chickenpox - Herpes Zoster. This virus is also strange. Unlike the previous ones, there are oddities here by age category.
If chickenpox, as everyone knows, is, as a rule, an exclusively childhood disease (although there are exceptions), herpes zoster is basically an infection that affects people after 35-45 years of age and older.
It is better if children get sick in childhood with infections such as chickenpox (chickenpox), rubella, measles, because in adulthood they can lead (for example, measles) to subacute sclerosing panencephalitis, a terrible disease, or chickenpox can turn, transform in Zoster.
If a child has had chickenpox, then 80 percent of the time he will not get sick as an adult. But chickenpox, unlike measles, does not provide lifelong 100 percent immunity, and therefore approximately 20 percent of those who had chickenpox in childhood will be “lucky” to subsequently also have the opportunity to get sick with herpes zoster.
Zoster can affect the skin and mucous membranes of a person and give complications to the central nervous system, affecting the mucous membranes, ranging from the heel and feet to the scalp, that is, a huge distance - that’s what Zoster is. Just an omnivorous virus, polyvalent.
. Fourth type(Epstein-Barr virus) also has a number of oddities. Officially, the Epshane-Barr virus is considered an etiopathogen, the causative agent of infectious mononucleosis ((mononucleosis infectiosa, Filatov's disease, monocytic tonsillitis, benign lymphoblastosis) - an acute viral disease that is characterized by fever, damage to the pharynx, lymph nodes, liver, spleen and peculiar changes in blood composition), which is relatively safe, although it has its own aspects.
For Russians, Americans and Europeans, it proceeds like this: the main, basic characteristics are a temperature of up to 39-40 degrees, which lasts for several weeks, severe tonsillitis and lymphadenopathy (swelling of the lymph glands).
However, in the Chinese, especially in the southern regions of China, the same virus causes cancer of the nasopharynx (nasopharyngeal carcinoma) - that is, apparently, the virus behaves as an endemic.
And in youth and young adults (the so-called young adults - 20-25 years old and slightly below) on the African continent, the same infectious mononucleosis virus can cause Burkett lymphoma, a malignant tumor of the upper jaw.
. Fifth type- cytomegalovirus (cyto - cell, megalo - large), in fact it is a herpes virus, it is a cousin of such prototypical herpes viruses as the first type virus, which causes “fever” on the lips.
Cytomegalovirus is also known as a virus that cause pathology during organ and tissue transplantation, and also as one of the main pests in pathologies of pregnancy, fetus, newborn.
If herpes viruses of the first, second type or Zoster (i.e., type three) mainly affect either the skin mucous membrane or give complications to the brain (meningitis, arachnoiditis, and so on), then the cytomegalovirus mainly affects the internal organs - this is the liver. kidneys, lungs, heart.
. Sixth type is divided into two options:
(i.e., associated with cell proliferation - tumors, for example),
of a rather severe nature, such as hemocytoblastosis, lymphoma, lymphosarcoma, etc.
— type six "B" associated with sudden exanthema (fine-grained rash).
. Seventh type- suspected to be one of the main etiopathogens
chronic fatigue syndrome.
. Eighth type is the etiopathogen of Kaposi's sarcoma in AIDS.
The most important biological property of herpes viruses in the pathogenesis of diseases is their ability to exist latently.
Herpes viruses are capable of persisting in the human body for life and causing diseases with diverse clinical manifestations: acute and chronic recurrent infections.
With damage to the skin and mucous membranes, internal organs, and central nervous system; transplacental infections affecting the fetus; lymphoproliferative diseases.
One of the most common human viral infections is herpes simplex, which represents a serious medical and social problem.
At least about 90% of people on the globe are infected with HSV, but only about 20% have any clinical manifestations of infection. Doctors of many specialties encounter this disease in their practice.
More thorough selective studies give reason to believe that almost all inhabitants of planet Earth are carriers of the vast majority of herpes viruses.
It has long been known that almost all of us are infected from the age of 3-5, in particular, with the Epstein-Barr virus. Data on infection with the first type of virus have varied somewhat over the past 15-20 years.
In fact, today even figures are given for people aged 60-65 years - 99.9 percent of the population of planet Earth.
But if the entire family of herpes viruses is our constant companions, then why does it happen that some people still get sick, in particular with the same “fever,” while others do not? What is the difference then between people?
Herpes viruses are widespread, and if the body allows them to function on itself, the disease cannot be avoided - unless you live your whole life in a sealed sterile box.
When infected, the herpes virus integrates into a human cell and changes its genetic apparatus. And, using its enzymatic apparatus, it switches the cell to the synthesis of its mature viral particles - virions, which in turn infect more and more new cells of the body in an avalanche-like manner, which leads to the development of herpetic disease.
Viral diseases can only be dealt with by the body’s immune defense, which recognizes emerging cells with altered genetics and destroys them, preventing the production of virions.
Viruses are ubiquitous and constantly attack all living things. Therefore, in the body of a healthy person, about 3 thousand affected cells are identified and destroyed every second- immune reactions continuously fight around the clock to maintain viability in the environment, providing protection from the many different types of pathogenic microflora that inevitably penetrate the body.
But each person’s body is individual, and so is their immune defense, an immune barrier that does not allow any cells with altered genetics in relation to a given organism to function and reproduce.
Disturbances in the functioning of the human immune defense, in which the body does not effectively recognize cells with altered (foreign to the body) genetics, lead to an uncontrolled increase in the number of affected cells.
This leads to the development of viral and other infectious diseases, and in more severe cases, to the development of oncological processes, which are also characterized by uncontrolled proliferation of cells with an altered genetic apparatus (cancer cells).
Therefore, viral diseases that last a long time or occur in a severe form are considered in modern medicine as precancerous conditions.
The virus can also infect blood cells - these include red blood cells, erythrocytes, and lymphocytes. In viral infections, as a rule, incomplete phagocytosis, that is, phagocytes and mononuclear cells are not able to completely kill the virus.
Therefore, in fact, conditions are created for the persistence of the virus in the body and for it to exist in the body for life. And then - depending on the decrease in immunity at different times for various reasons - it will remind you of its presence every time.
So it’s better to live without unnecessary physical and psychological stress, because such factors can affect the impairment of immunity and, accordingly, the stimulation and reactivation of the virus.
This is hypothermia, overheating, change of time zones, climatic chaos, when we are on a plane once - and in the subtropics, from minus 25 to plus 25, strong long-term neuropsychic experiences.
And besides this, of course, excessive consumption of alcohol, antibiotics, sulfonamides, hormones, which also seriously disrupt the functioning of the immune system.>
It has been known for 15-20 years that corticosteroids, glucocorticoids, that is, any hormonal drugs introduced into the human body, sharply stimulate, in particular, herpes virus and cytomegalovirus infections.
HSV multiplies intracellularly. The affected cells, predominantly epithelial, increase in size and inclusions appear in their nuclei.
Intranuclear inclusions during herpetic infection are divided into two types:
A - characterized by a general reaction with the presence of one large inclusion and
B - with limited nuclear reaction, when inclusions look like small “droplets” in the nuclear mass.
At a late stage of the process, intranuclear inclusions are stained by Feulgen, as they are rich in DNA, and do not contain RNA when stained by Brachet, glycogen, lipids, acid and alkaline phosphatase.
Structural changes in the organs of children who died from herpetic infection caused by HSV-1 and HSV-2 are practically no different from each other.
They are characterized by an increase in the size of the affected cells, mainly of epithelial origin, and their nuclei, fragmentation of chromatin, the marginal location of its clumps in the nucleus, clearing of the central part of the nucleus with the presence of a large basophilic or eosinophilic inclusion, as well as small-clumped cell disintegration.
With the most pronounced alternative changes, the death of individual cells or their groups is observed with the formation of foci of necrosis.
There is usually no cellular inflammatory response around alteration sites.
In addition, circulatory disorders and some other nonspecific changes are detected. With a longer duration of the disease, phenomena of regeneration and organization of exudate are observed.
Classification of herpes infection
According to the mechanism of infection.
1. Purchased:
- primary;
- recurrent (secondary).
2. Congenital (intrauterine infection).
According to the form of the infectious process.
1. Latent - asymptomatic carriage.
2. Localized.
3. Common.
4. Generalized (visceral, disseminated).
According to the location of the lesions.
1. Skin: herpes simplex, eczema herpetiformis, ulcerative necrotizing herpes, zosteriform herpes.
2. Mucous membranes of the oral cavity and oropharynx: stomatitis, hepatitis, glomerulonephritis.
According to the severity of the disease.
1. Lightweight.
2. Moderate.
3. Heavy.
Primary herpetic infection develops
at the first contact of a person with the virus at any age and in 80-90% of cases it occurs in a subclinical form.Clinically expressed primary herpes simplex is most often recorded in children aged 6 months to 5 years.
The incubation period lasts from 2 days to 4 weeks.
The most common form of primary herpes in children is aphthous stomatitis and acute respiratory disease. Various lesions of the skin, conjunctiva and cornea of the eye may be observed.
With the onset of sexual life, genital herpes is a common manifestation of the primary infection.
All manifest forms of primary herpes are characterized by a pronounced intoxication syndrome: fever, general weakness, headache, muscle and joint pain.
Recurrent (secondary) herpes infection associated with the reactivation of a virus that was latent in the human body. Relapses of the disease can occur with varying frequencies: from once a year to several times a month.
The localization of lesions in recurrent and primary herpes simplex usually coincides. The most common forms of recurrent herpes are skin and genital. With relapse of the disease, the general syndrome of intoxication and inflammatory changes in the lesion are usually less pronounced.
Localized herpes simplex, both primary and recurrent, has a clearly limited localization of the process.
The common form is characterized by deepening of the lesion, its spread to nearby tissues, and the appearance of new lesions in distant areas of the skin and mucous membranes.
This form of herpes develops in patients, usually with immune deficiency.
For generalized herpetic infection There are visceral and disseminated forms.
The visceral form is characterized by damage to any organ or system. The most common cases are meningitis and meningoencephalitis, less often - hepatitis, pneumonia, etc.
Disseminated the form is characterized by the involvement of many organs and systems in the pathological process, fever, severe intoxication, and hemorrhagic syndrome. This form of herpes develops in children under the age of 1 month and with severe immune deficiency and HIV infection.
Skin lesions
With herpes simplex, the skin of the face in the area of the lips (herpes labialis) and wings of the nose (herpes nasalis) is most often affected. Less commonly, rashes are localized on the forehead, cheeks, ears, lower back, genitals, fingers and other places.
1-2 days before the appearance of the rash or simultaneously with the appearance of the rash, swelling, hyperemia, burning and itching of the skin may be observed.
The typical form of herpes simplex of the skin is characterized by the formation of grouped papules on edematous-hyperemic skin, turning into vesicles with serous contents. The number of elements varies from single to several dozen. The size of the vesicles is from 1 to 4 mm; in rare cases, when they merge, multi-chamber bubbles are formed.
After a few days, the contents of the vesicles become cloudy and when they are opened, erosions form, which within 3-5 days are covered with yellow-brown crusts, under which epithelization occurs. Regional lymphadenitis may be observed 3-5 days from the onset of the disease.
In addition to local manifestations, especially in children, with skin herpes there may be signs of general intoxication: general weakness, fever, headache, etc.
After 6-9 days from the onset of the disease, the crusts fall off, and gradually disappearing pigmentation remains in their place. In typical cases, the entire process lasts 1-2 weeks.
Skin lesions with herpes simplex can occur in atypical forms:
The abortive form is characterized by the limitation of the inflammatory process by the development of erythema and edema without the formation of vesicles. This form of infection includes cases of the appearance of subjective sensations characteristic of herpes in places where it is usually localized in the form of pain and burning, but without the appearance of a rash.
The edematous form differs from the typical form by severe swelling of the subcutaneous tissue and hyperemia of the skin (usually on the scrotum, lips, eyelids); vesicles may be completely absent.
Zosteriform herpes simplex, due to the localization of rashes along the nerve trunks (on the face, torso, limbs), resembles herpes zoster, but the pain syndrome is less pronounced.
The hemorrhagic form is characterized by hemorrhagic vesicular contents instead of serous ones, often followed by the development of ulcerations.
The ulcerative-necrotic form develops with severe immune deficiency. Ulcers form on the skin, extensive ulcerative surfaces with a necrotic bottom and serous-hemorrhagic or purulent discharge, sometimes covered with crusts. The reverse development of the pathological process with the rejection of crusts, epithelization and scarring of ulcers occurs very slowly.
Eczema herpetiformis (varioliform pustulosis of Julisuberg-Kaposi) develops in children, less often in adults suffering from simple eczema or atopic dermatitis, as well as those with immune deficiency.
The disease is characterized by an acute onset, fever with an increase in body temperature to 40 ° C, and a pronounced intoxication syndrome. Multiple erythematous-pustular, papulovesicular, and bullous rashes appear on the skin. Subsequently, extensive erosive surfaces form and a secondary bacterial infection occurs.
The disease is very severe and can be fatal.
Damage to mucous membranes
Stomatitis, gingivitis, and pharyngitis tonsillitis are the most common manifestations of primary infection caused by HSV-1 and are more common in children and young people.
The disease is characterized by an acute onset, fever, severe intoxication syndrome, the appearance of multiple blisters against the background of catarrhal inflammation (hyperemia, swelling) of the mucous membranes of the gums, cheeks, tongue, palate, tonsils, and pharynx.
The blisters burst after 1-3 days, and erosions and aphthae form in their place. Characterized by moderate pain in the affected areas, difficulty eating, and drooling. The duration of the disease usually corresponds to 1-3 weeks. There are mild, moderate and severe forms of the disease.
When the disease relapses, compared to primary herpes, the intoxication syndrome is less pronounced or even absent. However, in the presence of immune deficiency, the inflammatory process can spread deep into the lungs.
The herpes virus, which causes herpes infection, enters the human body in different ways - household, airborne, contact, nutritional and others. Therefore, anyone, both adults and children, can easily become infected with this infection. Herpes infection is a disease, the main clinical manifestation of which is the appearance of a group of blisters on hyperemic mucous membranes and skin.
In cases where a newborn child exhibits manifestations of a generalized form of this viral pathology, it is necessary to make a differential diagnosis to exclude the possibility. Differential diagnosis is carried out by taking into account all the symptoms, as well as using and examining scrapings from the site of the lesion.
Treatment of a disease such as herpes infection requires an integrated approach. Appropriate measures can be prescribed only after diagnosis and identification of the pathogen.
The basis of treatment is the prescription of antiherpetic drugs - most often acyclovir (Zovirax) is used in the form of tablets, ointments and gels. In case of mild symptoms and a localized process, the use of local remedies is sufficient; in case of recurrent infection and spread of the virus, oral medications are required.
Primary herpes is treated within 10 days, but if the infection is recurrent and constantly appears, then its treatment will be long-term and can last up to a year - and the tablets should be taken in courses as prescribed by the doctor.
Note that a chronic infection can be asymptomatic for many years, but nevertheless, its treatment requires taking antiviral drugs if the diagnosis is confirmed by laboratory tests. In the case of a generalized form, intravenous administration of antiherpetic drugs is necessary.
It is imperative to increase the body’s protective functions, for which patients are prescribed immunomodulating drugs. Physiotherapy has also found wide application in the fight against herpes infection, in particular procedures such as ultraviolet irradiation, magnetic therapy and infrared irradiation of the affected areas are indicated.
Please note that during the period when a rash appears on the skin, mucous membranes or genitals, direct contact (including sexual contact) should be avoided to avoid infecting other people with the herpes virus.
As mentioned above, it is extremely difficult to prevent the herpes virus from entering the body, because it can enter in any way. However, in order to prevent the development of herpetic infection in newborns who can get it from a sick mother, delivery by cesarean section is recommended, which is carried out before the sac with amniotic fluid ruptures.
In addition, if there is a suspicion of intrauterine infection of the fetus with a herpes infection, acyclovir therapy is mandatory - the dose of the drug is selected individually, taking into account the severity of the disease.
As for the prevention of infection with such a pathology as herpetic infection in adults, it is absent and we can only recommend being careful about your contacts and not interacting with people who have herpetic rashes on their skin or mucous membranes.
In addition, increasing the protective functions of the body is of great importance for the prevention of viral pathology - good immunity is able to control the herpes virus in the body and prevent it from manifesting and spreading.
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Generalized herpes is a term for an acute infectious disease in humans, the appearance of which is provoked by a DNA virus. There are only two sources of this infection:
At the same time, there are many more ways of infection, since the herpes virus can enter the body through common objects, through close contacts (including kissing), and from a sick pregnant woman to the fetus.
The type of virus that causes herpes is dermatoneurotropic. This means that it is able to penetrate the skin and mucous membranes, where the virus multiplies and manifests itself - the appearance of herpetic blisters follows. If there is a suspicion of generalized herpes, treatment should begin immediately after confirmation of the diagnosis, since the next stage in the development of the disease is the penetration of the virus into the blood, and it also affects regional lymph nodes - and the patient develops septic viremia.
There are primary and secondary forms of the generalized type of the disease. If a primary infection has occurred, its first signs usually appear after the incubation period has passed, which can last from two days to two weeks. If a person has already suffered from this disease at least once, then all subsequent infections are considered secondary and they no longer arise due to contact with a patient or carrier, but due to the influence of unfavorable factors on the body.
Most often, generalized herpes is diagnosed in newborns. The onset of the disease is acute: the temperature rises sharply to extremely high levels. The child does not eat and may experience diarrhea and vomiting. The occurrence of seizures is possible. Examination, as a rule, reveals the presence of a specific rash on all mucous membranes accessible to inspection, as well as on the lungs and walls of the esophagus. Unfortunately, mortality in such cases has depressing indicators: nine out of ten newborns die from the generalized form of this infection.
If the diagnosis is confirmed by the results of clinical studies, it is necessary to begin a course of treatment as soon as possible. It consists of administering antiviral drugs, most often orally, as well as mandatory detoxification therapy.
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