Herpes simplex

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Contents

Introduction

The Herpes simplex virus (HSV) is the cause of cold sores, sexually transmitted disease (genital herpes) and ulcers. Accordingly a very successful virus as it infects over 60% of those under 50 worldwide although incidence is slightly lower in the Americas[1][2]. Neonatal herpes simplex can be a serious disease as can herpes simplex encephalitis. It is a likely cause of Bell's palsy.

Aetiology

Herpes simplex virus (HSV). Large, complex, DNA. There are two types of HSV, HSV 1 and HSV 2. Like other members of the family Herpesviridae, HSV establishes lifelong latency. HSV can reactivate when the host is immunocompromised, although the exact trigger is often not identified.

Taxonomy

Clinical

HSV 1 is usually associated with oral HSV infections. HSV 2 is usually associated with genital herpes infections. However either HSV type can be found at either site.

  • Cold sores
  • Genital herpes
  • HSV encephalitis
  • Characteristic rash
  • Association rash and systemic or CNS disease

Investigations

Laboratory Tests

  • Direct fluorescent antibodies
  • Tzanck preparation
  • Immunofluorescence using HSV specific monoclonal antibodies
  • HSV DNA PCR
  • Cell culture
  • HSV serology by ELISA. Both type-specific and non type-specific HSV serology are available.
  • Lumbar puncture in suspected viral encephalitides

Radiology

  • MRI and CT in suspected encephalitis

Treatment

Medical

Prevention

Notification

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