Klinika - příznaky

Genitální herpes HSV

• Most common cause of recurrent genital ulcer disease (GUD) worldwide
• Symptomatic genital HSV is a lifelong condition
• Frequent symptomatic recurrences

First episode of - primary genital HSV infection

• First-episode infections of genital herpes are more extensive
• Primary lesions last two to six weeks versus approximately one week for lesions in recurrent disease. [2]
• Most initial infections are asymptomatic or atypical
• Majority of people with HSV-2 infection have not been diagnosed
• HSV-1 and HSV-2
• Usually transmitted by different routes
• Signs and symptoms overlap

Inkubační doba

• Occurring 4–7 days after sexual exposure

Genitál

• Classical syndrome occurs only in 10–25% of primary infections
• Genital pain and itching
• Bilateral clusters of erythematous papules, vesicles or ulcerations on the external genitalia
• In the perianal region or on the buttocks
• 80% of women also report dysuria
• Over a period of 2–3 weeks, new lesions appear
• Existing lesions progress to vesicles and pustules
• Coalesce into ulcers before crusting over and healing
• Lesions on mucosal surfaces may be ulcerative without initially presenting as vesicles

Doprovodné symptomy

• First clinical episodes can also be associated with central nervous system, fever and flu-like symptoms.
• Fever, headache, myalgias and malaise are common
• Infection with HSV-2 also may increase the risk of acquiring HIV infection.
• Cervicitis and tender inguinal and femoral lymphadenopathy frequently accompany initial infections

Atypical presentations - HSV-2

• Small erosions and fissures
• Dysuria or urethritis without lesions

Recurrent HSV2

• After initial infection, chronic HSV-2 infection
• Typically leads to intermittent viral shedding from the genital mucosa
• Even in the absence of symptoms
• Is often transmitted by people who are unaware of their infection
• Are asymptomatic at the time of sexual contact
• Recurrences are often preceded by prodromal symptoms
• Tingling,
• Paresthesias and pain
• Fewer lesions than the first episode
• Usually present unilaterally and without systemic symptoms
• Pain is less severe during recurrences
• Lesions heal in 5–10 days without antiviral treatment

First infection - genital HSV-1

• Cannot be clinically differentiated from genital HSV-2 infection
• Only through laboratory tests
• Most people will experience one or more symptomatic recurrences
• Within one year after the first symptomatic episode of HSV-2 infection

Recurrent genital HSV-1

• Symptomatic episodes are much less likely to recur
• Symptomatic recurrences are generally less severe than the first episode

Immunocompromised patients and HSV

• Snyrgic with HIV
• Generally have more frequent recurrences with more severe symptoms
• Recurrent ulcers can cause significant physical and psychological morbidity

HSV-1 přenos

• Mainly transmitted by oral-to-oral contact
• Cause oral herpes infection
• Via contact with the HSV-1 virus in
• Sores,
• Saliva
• Surfaces in or around the mouth
• HSV-1 can also be transmitted to the genital area through oral-genital contact to cause genital herpes.
• Can be transmitted from oral or skin surfaces that appear normal and when there are no symptoms present
• Greatest risk of transmission is when there are active sores.
• Who already have HSV-1 oral herpes infection
• Are unlikely to be subsequently infected with HSV-1 in the genital area (???) [3]
• Rare circumstances, HSV-1 infection can be transmitted from a mother with genital HSV-1 infection to her infant during delivery [3]