Herpetic Infection - Treatment In Children And Adults

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Herpetic infection

The content of the article:

1. Causes and risk factors
2. Forms of the disease
3. Disease stages
4. Symptoms
5. Diagnostics
6. Treatment of herpes infection
7. Possible complications and consequences
8. Forecast
9. Prevention

Herpes infection is a group of infectious diseases caused by the herpes simplex virus. A feature of herpes infection is the ability of the infectious agent to remain inactive for a long time, persisting in the nerve ganglia (the herpes virus of the first type, as a rule, circulates in the cervical, and the herpes virus of the second type - in the lumbar ganglia). The disease and its relapses develop only with a decrease in immunity.

Source: boleznikogi.com

According to some reports, by the age of five, about 85% of the population is infected with the herpes simplex virus. Antibodies to the virus are found in almost 100% of adults. Moreover, the clinical manifestations of herpes infection in adults occur in 10–20% of cases.

Causes and risk factors

The causative agent of herpes infection is a DNA-containing virus of the herpesvirus family, which is of two types:

• herpes simplex virus type 1 - mainly affects the skin and mucous membranes of the oral cavity, nose, eyes, neck, central nervous system;
• herpes simplex virus type 2 - causes damage to the urogenital tract.

The reservoir of infection is a sick person or a virus carrier. The main routes of transmission are airborne, contact-household, sexual, transplacental infection and infection during childbirth are also possible. In addition, self-infection is possible when the virus penetrates from infected organs and tissues into healthy ones. The susceptibility of people to an infectious agent is high, however, in most cases, asymptomatic virus carriers are observed. The transition of herpes infection from a latent to a manifest state is facilitated by hypothermia of the body, other immunodeficiency states, stress, treatment with certain medications (immunosuppressants, glucocorticoids), exposure to the body of ionizing radiation, etc.

The herpes simplex virus enters the human body through damaged skin and / or mucous membranes and rapidly multiplies in cells. Due to its enhanced reproduction, epithelial cells die with the formation of a vesicular rash, and then erosions and crusts on the affected areas of the skin and mucous membranes. After the resolution of the disease, the virus remains in the body for life, staying in a latent form in the nerve ganglia.

Virions are rapidly destroyed by high temperatures, ultraviolet radiation, the action of ether, formaldehyde and phenol, but they persist for a long time at low temperatures, are resistant to thawing and re-freezing, as well as to ultrasound.

Forms of the disease

Herpetic infection can be congenital and acquired.

Depending on the localization of the pathological process, lesions of the skin, mucous membranes, internal organs, eyes, nervous system, etc. are isolated.

Depending on the degree of spread, herpes infection is divided into localized, widespread, generalized.

On clinical grounds, the disease can be typical or atypical.

Depending on the severity, mild, moderate and severe forms of the disease are distinguished.

Disease stages

During herpes infection, the following stages are distinguished:

1. The stage of harbingers.
2. Hyperemia.
3. Vesicle stage.
4. Erosion formation.
5. Crust formation.
6. Healing stage.

Symptoms

The incubation period for herpes infection is usually two days to two weeks. The onset of the disease can be either acute or gradual. Relapses of herpes infection can develop frequently - usually it occurs in immunocompromised patients, in most cases, they occur 1-2 times a year or less often.

Recurrent skin herpes is the most common form of recurrent herpes. Its main clinical manifestation is a vesicular rash, which is usually localized on the wings of the nose or in the perioral region. Less commonly, vesicular rashes occur on the eyelids, upper limbs, trunk, buttocks and in the genital area. The elements of the rash are surrounded by a zone of hyperemia, filled with serous fluid, which subsequently becomes cloudy. The onset of rashes is preceded by itching, burning, hyperemia and local hardening of the skin. The general condition of the patient with this form of the disease remains satisfactory. After the rash has resolved, no trace remains on the skin. When a secondary bacterial infection is attached, the rash takes on the character of purulent ulceration, the healing of the elements of the rash is difficult,after their resolution, scars may form.

Source: simptomer.ru

Primary herpetic gingivostomatitis with pharyngitis usually has an acute onset. Patients have an increase in body temperature to febrile values, chills, sore throat, hyperemia and swelling of the pharynx. On the mucous membrane of the oral cavity, hard and soft palate, palatine arches, tonsils, vesicular rashes with serous contents appear. The elements of the rash ulcerate with the formation of painful erosions that make it difficult to eat. Bleeding of the affected mucous membranes, increased production of saliva, and bad breath are noted. Cervical, mandibular and chin lymph nodes enlarge, become painful on palpation. Healing of erosion takes place within 1-2 weeks.

With the development of herpetic keratoconjunctivitis, damage to one eye develops, accompanied by regional lymphadenopathy. It manifests itself in edema of the conjunctiva and sclera, vesicular rashes on the eyelid. The inflammatory discharge is serous in nature. Sometimes this form of the disease takes the form of treelike keratitis, which causes the development of spotty opacity of the cornea of the eye, a decrease in the sensitivity of the cornea, and deterioration of vision.

Herpes of the lips is manifested by a sensation of pain, burning, itching in the area of the red border of the lips, followed by the appearance of rashes, their ulceration, and the formation of crusts. The duration is 1–2 weeks.

Source: popular- medicine.rf

The defeat of internal organs takes the form of herpetic pneumonia, pancreatitis, hepatitis, nephritis, etc., with symptoms characteristic of the defeat of one or another organ.

Herpetic infection of the nervous system takes the form of serous meningitis, encephalitis, or a combination of these - meningoencephalitis. This is one of the most severe forms of the disease.

Primary genital herpes is often asymptomatic, while the infectious agent persists for a long time in the cervical canal in women or in the urethra in men. For recurrent genital herpes in men, a vesicular rash is characteristic of the inner layer of the foreskin, as well as on the head and body of the penis. The urethra and bladder can be involved in the pathological process. The appearance of a rash is accompanied by a burning sensation, painful sensations during urination and intercourse, an increase in regional lymph nodes. In women, a vesicular rash usually occurs on the thighs, in the perineum, on the labia minora and labia minora, the clitoris, and in the vagina. Painful sensations can occur not only directly at the site of the rash, but also in the lower abdomen, lower back, sacral region.

Against the background of immunodeficiency states, as well as in newborns, herpes infection can take a generalized form, characterized by a severe course. The disease is accompanied by intoxication of the body, profuse rashes on the skin and mucous membranes of the oral cavity, pharynx and esophagus, perianal region, an increase in the size of the liver and spleen (hepatolienal syndrome), polyadenopathy. Patients develop dyspeptic disorders, convulsions. This form of the disease lasts from several days to 2-3 weeks. In the most severe cases, patients may develop pneumonia, progressive esophagitis, colitis, and neurological disorders.

Herpetic eczema is a form of generalized herpes that usually develops in children with neurodermatitis or eczema. In patients, signs of intoxication of the body are expressed, a diffuse rash appears, which resembles a rash with syphilis (it has an umbilical depression, can take on a drainage character, after its resolution, scars may remain on the skin), local edema develops, and lymph nodes increase.

Diagnostics

Diagnosis of herpes infection is based on clinical signs of the disease: characteristic vesicular rashes, enlargement of regional lymph nodes in combination with signs of general intoxication of the body. To clarify the diagnosis, they resort to laboratory tests.

If a herpetic infection is suspected, laboratory tests are carried out using the methods of polymerase chain reaction, enzyme immunoassay in paired sera, complement binding reactions, and indirect immunofluorescence. At the same time, an increase in the IgM titer by 4 or more times testifies in favor of the primary herpes infection, a four-fold increase in the IgG titer indicates the presence of a recurrent herpes infection.

Detection and identification of an infectious agent can be carried out using a virological examination of the contents of vesicles, nasopharyngeal lavages, erosion scrapings, as well as blood, urine, cerebrospinal fluid, ejaculate, and in case of death - brain biopsies. The virus is grown in chicken embryos or in tissue cultures, but this type of research does not give an idea of the activity of the infectious process.

With a generalized form of the disease, an immunological examination, a test for HIV infection is performed.

Differential diagnosis is carried out with vesicular dermatoses, chickenpox, gingivostomatitis and genital ulcers of a different etiology.

Treatment of herpes infection

Treatment of herpes infection is selected depending on the form and severity of the disease.

In the absence of complications, therapy is carried out on an outpatient basis. Hospitalization is indicated in the case of a severe course of the disease, with generalized forms, in case of complications, especially from the nervous system, as well as with herpetic lesions of the eyes.

For localized forms of the disease, local therapy is sufficient. Cold compresses with drugs with antiviral activity are used. When a secondary bacterial infection is attached, local antibacterial drugs are used. The course of treatment with antiviral drugs for primary herpes lasts up to 10 days. In the case of frequent relapses, treatment is longer, up to a year. During periods of remission, such patients are shown to take immunomodulators, herbal adaptogens, sometimes vaccine therapy, physiotherapy (magnetotherapy, ultraviolet radiation therapy, infrared radiation, high-frequency therapy).

With severe pain syndrome, drugs from the group of non-steroidal anti-inflammatory drugs are prescribed.

In severe cases of herpes infection, as well as in the case of resistance to the treatment, they resort to intravenous laser irradiation of blood.

Patients are shown vitamin therapy (especially vitamins B ₁, B ₆, B ₁₂), it is recommended to follow a sparing diet and drink plenty of fluids.

Possible complications and consequences

Herpetic infection can be complicated by lesions of the central and peripheral nervous system, damage to joints and internal organs, generalization of the infectious process with a fatal outcome. Herpes eye disease can cause blindness. Genital herpes can lead to abnormalities in pregnancy and childbirth.

Forecast

With timely, correctly selected treatment, the prognosis for life is favorable.

With the development of herpetic infection with damage to the central nervous system, as well as if the patient has acquired immunodeficiency syndrome, the prognosis is usually poor. There is a high risk of death or the development of severe complications from the central nervous system.

With intrauterine infection of the fetus, the prognosis depends on the gestational age at which the fetus was infected. Infection of the fetus in the first trimester of pregnancy, as a rule, leads to its death and termination of pregnancy, and if this does not happen, to the appearance of malformations of varying severity.

Prevention

In order to prevent the development of herpes infection, it is recommended:

• timely seeking medical attention for any skin diseases;
• avoiding close contact with patients with herpes infection during an exacerbation;
• avoiding accidental unprotected sex;
• strengthening the body's defenses;
• rejection of bad habits;
• compliance with the rules of personal hygiene.

To prevent the development of congenital herpes infection in children, women during pregnancy are advised to exclude contacts with people suffering from herpes, avoid crowds of people, timely register for obstetric care, eat well, and avoid psychoemotional and physical overstrain.

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Anna Aksenova Medical journalist About the author

Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".

The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!