Herpetic infection

Herpetic infection - diseases caused by the herpes simplex virus; Characterized by damage to the skin and mucous membranes, in some cases can cause damage to the eyes, the nervous system and internal organs.

Etiology, pathogenesis. The causative agent belongs to the herpes family, it is divided into 6 antigenic groups. The most common type is 1; With type II virus, the occurrence of genital herpes and generalized infection of newborns is associated. Gates of infection are the skin and mucous membranes. After the introduction, the herpes virus persists in the human body for life in the form of a latent infection, which can pass into wedge-shaped forms under the influence of weakening factors (influenza and other diseases, treatment with immunosuppressants, AIDS, etc.).

Symptoms, course. The incubation period is 2-12 days (usually 4 days). Primary infection usually proceeds subclinically, only in 10-20% of patients there are different clinical manifestations. The following clinical forms are distinguished: 1) herpetic skin lesions (localized and common); 2) herpetic lesions of the oral cavity; 3) ARI; 4) genital herpes; 5) herpetic damage to the eyes (superficial and deep); 6) encephalitis and meningoencephalitis; 7) visceral forms (hepatitis, pneumonia); 8) generalized herpes of newborns. Localized herpetic skin lesions are the most frequent, they usually accompany some other disease (ARI, malaria, meningococcal infection, etc.). General symptoms are absent or masked by manifestations of the underlying disease. Vesicles are localized around the mouth, on the lips, on the wings of the nose. In some cases, there is a common herpes rash. The defeat of the mucous membranes of the oral cavity usually takes the form of aphthous herpetic stomatitis. Herpes viruses account for 5-7% of all ARI; Clinically they differ little from ORZ of other etiology.

Genital herpes, sexually transmitted, occurs more often in the form of necrotic cervicitis, herpetic lesions of the vagina and external genitalia. This form promotes the emergence of cervical cancer, in pregnant women is a danger to the fetus (severe generalized herpes of newborns can occur). Herpetic lesions of the eye often occur in the form of superficial and deep lesions of the cornea. The disease is prone to a prolonged recurrent course. May cause persistent opacity of the cornea. Severe herpes encephalitis, they often end lethal. Visceral forms of herpes usually occur against a background of massive treatment with various immunosuppressants, as well as in AIDS patients, are more often manifested in the form of hepatitis, pneumonia, and encephalitis. Genitalized herpes of newborns with encephalitis, skin and internal organs, without treatment with antiviral drugs usually ends lethal.

Diagnosis of herpetic infection is facilitated by the presence of characteristic lesions of the skin or mucous membranes. To confirm the diagnosis, the virus is isolated from a variety of materials (contents of vesicles, corneal scrapings, cerebrospinal fluid, cervical biopsy material, etc.).

Treatment. With localized uncomplicated forms of herpetic infection, the main disease is treated, locally the elements of the rash are lubricated with a 1% solution of methylene blue or brilliant green. When crusts appear, tetracycline and erythromycin ointments are used. To prevent generalization of infection in / m injected 6 ml of normal human immunoglobulin. When suppuration of the elements of the rash, antibiotics are prescribed:

Oxacillin 1 g after 6 hours, erythromycin 0.5 g 4 times a day. To prevent eye damage, a 0.1% solution of 5-iodo-2-deoxyuridine (kerecid) can be instilled in the eyes. The same solution works well for herpetic lesions of the mucous membranes. Locally used leukocyte interferon.

The prognosis is doubtful when generalized herpes, herpetic encephalitis. If the eyes are affected, there may be a prolonged recurrent course, which leads to disability.

To prevent generalization of infection, normal human immunoglobulin (6 ml every 3 weeks) is administered. To prevent recurrence, the killed vaccine from the herpes virus is effective. There are no events in the outbreak.