Sunday, April 5, 2009

Herpes Simplex Infections

HSV Infections
Asymptomatic, mucocutaneous, neonatal, CNS, latent
Type 1: gingivostomatitis, whitlow, keratoconjunctivitis, encephalitis, eczema
herpeticum
Type 2: genital HSV, meningitis
Classification: primary; non primary, first episode; recurrent, reinfection Latency: sensory or autonomic neurons; LATS Reactivations: trauma, sunlight, stress (despite antibodies) Host: normal vs. immunocompromised

Neonatal HSV Infections
Congenital 5%; most HSV 2 (poorer prognosis)
Most mothers asymptomatic; antibodies may modify
Attack rate after primary maternal infection over 50% (> 10 times
than after recurrent infection) Cesarean section controversial in women with recurrent HSV at delivery Culture baby (eye, skin, throat) after 24 hours old Categories, prognosis: skin/eye/mouth, CNS, disseminated Symptoms: skin vesicles, fever, intractable seizures, pneumonia, DIC, conjunctivitis, recurrent skin vesicles after therapy
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