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Herpetic infection


HERPETIC INFECTION is a viral infectious disease of a person characterized by a variety of ways of transmission of the pathogen, damage to the skin, mucous membranes and nervous system, often a chronic recurrent course.

The causative agent is herpes simplex virus type I and II. Type I virus causes predominant damage to the skin and mucous membranes of the head (lips, mouth, eyes), type II - genitalia.

The source of the pathogen is a sick person or a virus carrier. Infection with type I virus occurs predominantly through contact and airborne droplets in childhood, with type II viruses — most often sexually, at an older age. It is also possible intrauterine infection of the fetus.

After the initial infection, the viruses remain mainly in the nerve ganglia. By reducing the body's resistance (infectious disease, cold, trauma, disorders in the immune system), viruses become more active, causing a relapse of the disease.

Primary infection is usually asymptomatic, but in 10–20% of patients there are clinically pronounced forms of the disease. The incubation period is from 2 to 12 days.

The following forms of herpes infection are distinguished: herpes lesions of the skin, mucous membranes of the mouth, eyes, acute respiratory disease, genital herpes, damage to the nervous system, visceral herpes, herpes of the newborn, generalized herpes.

Herpetic skin lesions often accompany flu , pneumonia, and other acute infectious diseases. At the same time, common symptoms are usually masked by manifestations of the underlying disease. Rashes are localized, as a rule, on the lips, wings of the nose. Initially, itching and burning of the skin, then its consolidation and groups of small bubbles with transparent contents, which then becomes cloudy. After opening the bubbles, erosions and crusts form; secondary suppuration possible. Regional lymph nodes are slightly enlarged, painful.

Herpetic lesions of the oral mucosa are manifested as acute or recurrent stomatitis. In acute herpetic stomatitis, fever , headache, and muscle pain are noted. Almost simultaneously, there is a burning sensation, tingling. On the mucous membrane of the gums, cheeks, soft and hard palate are grouped small bubbles with transparent contents, which then becomes cloudy. After the opening of the bubbles, painful erosions are formed, healing within 1-2 weeks. Relapse is possible.

With aphthous stomatitis the general condition of the patient is not disturbed. On the mucous membrane of the mouth, single large erosions are formed, which are slowly epithelized.

Acute respiratory diseases can occur without damage to the mucous membranes and are not clinically different from acute respiratory infections of a different etiology. At the same time, a rash of bubbles and the formation of erosion, which are located on the back of the throat, tonsils and oral mucosa, are less common.

Genital herpes is accompanied by moderate fever and intoxication, lower abdominal pain, in the lumbar region, an increase and tenderness of the inguinal lymph nodes, cutting and burning in places of eruptions. Rashes on the external genital organs in men are localized on the inner surface of the foreskin and the head of the penis, in women - in the perineum, on the large and small labia. The process can spread to the mucous membrane of the vagina, uterus, urethra. Combined lesions are possible when, along with genital herpes, herpes of the mucous membranes of the mouth and eyes are detected. Recurrent genital herpes contributes to cervical cancer.

Herpetic lesions of the eyes (ophthalmic herpes), especially in relapses, can lead to corneal opacity and blindness.

Herpes lesions of the nervous system can occur in the form of serous meningitis, which is not significantly different from other viral meningitis and is characterized by a benign course, and herpetic encephalitis. In the latter, high fever , deep disturbances of consciousness, convulsions , paresis and paralysis of various muscle groups are observed. Mortality is 30% or more. Those who have recovered often have severe residual lesions (paralysis, dementia).

Pneumonia and hepatitis are known from the visceral forms of herpes , esophagitis , pancreatitis , kidney, adrenal gland disease, etc. are possible.

Generalized forms of the disease are observed in newborns and those with a weakened immune system, in particular in HIV-infected. In this case, the phenomena of general intoxication are combined with common lesions of the skin, mucous membranes and internal organs. One of the forms of generalized herpes infection is the herpetiform eczema of Kaposi, which develops in children suffering from neurodermatitis, eczema and other chronic skin diseases.

The course of a herpetic infection can be acute (in case of primary infection) and recurrent. Recurrent damage to the skin of the face and oral mucosa is more often caused by type I virus, genitalia - type II virus. The frequency of relapses - from 2 - 3 times to many dozens.

The diagnosis of herpes infection is established on the basis of clinical data. The virus can be distinguished from herpes lesions, blood, cerebrospinal fluid, biopsy specimens of the cervical mucosa, etc. The diagnosis can also be confirmed by serological methods for increasing the antibody titer 4 or more times in the study of paired sera.

For treatment use acyclovir (zovirax), which, depending on the form of the disease, is applied topically, by mouth and intravenously. Patients with severe forms of the disease are hospitalized.

In order to prevent recurrence, acyclovir , an antiherpetic vaccine is also used, and the identified violations in the immune system are corrected.