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Herpes Simplex virus - (Herpesvirus  hominis) produces a variety of infections involving mucocutaneous surfaces, the central nervous system and occasionally involves visceral organs. It has two subtypes HSV-1, HSV-2.

HSV enters body on exposure to mucosal surfaces or abraded skin. Innitial infection with HSV may be subclinical and without any symptoms. 

During the initial phase of infection, viral replication occurs in ganglia and contiguous neural tissue. Virus then spreads to other mucosal skin surfaces through centrifugal migration.

The first episode of HSV disease is frequently accompanied by systemic signs and symptoms, involve both mucosal and extramucosal sites, and have a longer duration of symptoms, and a higher rate of complications than recurrent episodes of disease.

Spread - Transmission can result from contact with persons with active ulcerative lesions or with persons without clinical manifestations of infection who are shedding HSV. 

Asymptomatic salivary excretion of HSV is seen by 2 to 10 percent. These persons do not have any active lesions.  

Herpes Simplex - future

Clinical menifestations of HSV are:-

• Oral & Facial Infections - Involvement of gums, tongue and oral cavity is the most frequent clinical manifestations of first-episode HSV infection. Face and soft palate may also be involved. Recurrent herpes labialis (infections of lip) is the most frequent clinical manifestation of reactivation HSV infection.

  Symptoms of  fever, malaise, myalgias, inability to eat, irritability, and cervical adenopathy may also be present.

  Persistent ulcerative HSV infections are among the most common infections in patients with AIDS. HSV and Candida infections often occur concurrently.

• Genital Infections - First-episode primary genital herpes is characterized by fever, headache, malaise, and myalgias. Pain, itching, dysuria (pain on urination), vaginal and urethral discharge, and tender inguinal lymph enlargement. 

  Widely spaced bilateral lesions of the external genitalia are seen. Lesions may be present in varying stages, including vesicles, pustules, or painful erythematous ulcers. The cervix and urethra are involved in more than 80 percent of women with first-episode infections. Rarely HSV infection may manifest as Infection of prostate in men and infection of fallopian tubes in females.

• Herpetic Whitlow - infection of finger may occur as a complication of primary oral or genital herpes.

• Eye Infections- Causes corneal blindness. It is one of the main cause of blindness in US.

• Central And Peripheral Nervous System Infections - Causes viral encephalitis - acute onset of fever and focal neurologic (especially temporal-lobe) symptoms. HSV-1 has been implicated to cause Bell's Palsy (One sided facial paralysis). 

• Internal organ infections - esophagus, lung, or liver have been shown to be involved in HSV infection. Neonates and those with compromised immunological system may have generalized infection. 

  Treatment - Anti viral chemotherapy with Acyclovir is used to treat this infection.

Herpes Simplex - future

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