Herpes Infections
Herpes Infections
Herpes virus is a viral infectious disease that causes cold sores and is encountered by a significant portion of people throughout their lives....
What is Herpes Virus?
Herpes virus is a viral infectious disease that causes cold sores and is encountered by a significant portion of people throughout their lives.
How is Herpes Virus Transmitted?
Transmission by direct contact
It is transmitted by direct contact with the fluid inside the cold sore (vesicle fluid) or through contaminated items contaminated with this fluid.
Sexual transmission
Mostly seen due to HSV-2, it is transmitted through sexual contact, mucous membranes and damaged skin. 3-14 days after intercourse, herpes vesicles appear and then turn into painful eroded (slightly deep-seated) lesions.
Perinatal transmission
If a pregnant mother-to-be has an active herpes infection in the genital area during birth, there is a risk that the baby will be infected while passing through the birth canal during normal birth. Herpes virus symptoms in newborns appear after 5-10 days. In case of active genital infection, cesarean delivery may be recommended instead of normal birth to prevent perinatal contamination.
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HSV and What Diseases Does It Cause?
There are two different serotypes of HSV. They are HSVtype -1 and HSVtype-2. HSVtype -1 and HSVtype-2 usually affect different parts of the body. It progresses with skin and mucosa (intraoral, genital, eye, etc.) involvement.
Fasiyal-oral herpes simpleks
It is a herpes simplex infection that is mostly caused by HSV type-1 and is located on the face and mouth. The first encounter with HSV is usually at the age of 5-6, and it appears as a painful vesicle (water-filled blister) on the face, on the edge of the nose, in or around the mouth, accompanied by more severe symptoms such as fever, malaise, and headache. Generally, transmission occurs through saliva. While the first attack is more severe, the symptoms are calmer in recurrent infections. Recurrent infection is usually not accompanied by systemic complaints such as fever. Painful, itchy vesicles appear on the skin as lesions.
Rekürren (tekrarlayan)herpes labialis
After experiencing facial-oral herpes simplex infection for the first time, it remains latent (pending) in the body. The virus cannot be completely eliminated from the body. This herpes simplex virus infection, which remains dormant in situations such as stress, fatigue, insomnia, ultraviolet rays, trauma, fever, and decreased immunity, causes recurrent herpes labialis (herpes on the lip). Milder symptoms are observed compared to the first infection. It is observed as burning, stinging, vesicles/pustules (water-filled blisters) on the reddened surface. The lesions, which are wetter at first, begin to crust after three days and disappear without leaving a trace in about a week.
Oküler herpes
It is a herpetic infection of the eye. It is called herpetic keratoconjunctivitis. In adulthood, it usually occurs when people with herpes simplex infection problems on the face, nose or genitals rub their eyes. Apart from that, transmission from mother to baby with genital herpes due to HSV-2 can be observed while passing through the birth canal. It causes redness, vesicles, pustules and edema on the eyelids. In herpetic keratoconjunctivitis, ophthalmologist consultation is definitely required. Since there may be a risk of blindness due to scarring caused by keratitis, an ophthalmologist should also follow up.
Herpes Genitalis
It is a herpes simplex infection, mostly due to HSV-2, that develops in the genital area. We frequently see HSV among sexually transmitted diseases. Infection may occur and recur in predisposing conditions such as trauma, sexual intercourse, menstruation, stress, febrile illness, and decreased immunity. In men, it is located in the glans penis, scrotum, and perineum, while in women it is located in the labia major-minor, mons pubis, perineum, clitoris, and vagina. Melting (redness), erode (slight pit on the skin), vesicles (water-filled blisters), burning, stinging and pain can be seen as lesions. In recurrent genital herpes, even when there are no active skin findings, the virus remains latent. There is a risk of transmission even at this stage. Therefore, it is recommended that those with a history of recurrent genital herpes infection use a condom during sexual intercourse to prevent asymptomatic transmission. In case of active infection, sexual intercourse should be avoided.
Disseminated (common) herpes simplex infection
Apart from limited skin lesions, herpes simplex can rarely cause widespread skin lesions and internal organ damage.
It most commonly occurs when the mother, who had active genital herpes during pregnancy, transmits the infection to the baby through genital secretions during birth. Apart from this, immunosuppression, HIV infection and herpes simplex during pregnancy can rarely cause widespread skin lesions and internal organ damage other than limited skin lesions.
 
How to Treat HSV?
HSV treatment may vary depending on the patient's age, extent of lesions, pregnancy, immunosuppression, and affected areas. In the treatment of HSV, early treatment (first three days) is especially important. Initial HSV-1 and HSV-2 infections are more severe and systemic antiviral therapy is administered together with topical therapy.
Recurrent HSV infections are more localized and mild, and topical antiviral treatment is usually sufficient.
Suppression therapy may be planned for people who have very frequent HSV infections (six or more per year). In suppression therapy, systemic antiviral treatment is given for at least 6 months.
Intravenous (intravenous) antiviral treatment is applied in common HSV infections.
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