(GP)

Overview

• Two strains of HSV in humans → HSV-1 and HSV-2

• 90% of the world’s population over age of 40 carries HSV

• Transmission → via direct contact with mucosal tissue or secretions of another infected person. Infection with HSV-1 is usually acquired in childhood via saliva. HSV-2 is mostly spread through genital contact.
  • HSV-1 ⇒ more commonly causes herpes labialis (cold sores - oral herpes). Also associated with HSV encephealitis.
  • HSV-2 → causes genital herpes
• Risk Factors → HIV and immunosuppressive medications

Making Diagnosis

Clinical Features:

• Genital Ulcer → painful (may be multiple ulcers)
  • Dysuria and Pruritus → symptom of genital herpes
• Tender Inguinal Lymphadenopathy
• Oral Ulcer (Cold Sores - HSV1)
  • Tingling Sensation before appearance of lesion
• Erythema Multiforme (target lesions)
• Primary Infection → may present with a severe gingivostomatitis (erythema and painful ulcerations on the perioral skin and oral mucosa)

Eczema Herpeticum ⇒ severe primary infection of the skin by herpes simplex virus 1 or 2. Commonly seen in children with atopic eczema and often presents as a rapidly progressing painful rash. Punched out erosions are seen. Potentially life-threatening hence children should be admitted for IV aciclovir.

Investigations: