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Herpes Simplex Virus Infections

Any mucocutaneous surface or visceral site may be infected by HSV. Two strains of the virus, herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2), cause clinically indistinguishable lesions herpe.

Pathogenesis of Herpes Simplex

Both HSV-1 and HSV-2 may cause genital and orofacial lesions. In genital infections, recurrences are more commonly caused by HSV-2 than HSV-1.

Primary HSV infection occurs after first exposure, followed by a latency period while the virus remains dormant within the nerve ganglion , venereal disease, cold sores

Antibody studies have shown that 60% of all US adults are positive. The incubation period for primary HSV infections is 1-26 days.

Diagnostic Features of HSV Infection

The lesions consists of grouped vesicles or a solitary vesicle with erythematous bases, progressing to ulceration.

Primary infections may be accompanied by flu-like symptoms.

Prodromal burning or itching (in recurrent disease)

Lesions are painful and persist for several days forming a honey-colored crust. Healing is usually complete within 3 weeks.

Immunosuppressed patients, especially HIV infected patients, have more frequent and more severe infections.

Contact with ulcerative lesions or with secretions may result in transmission. Asymptomatic viral shedding may also cause infection.

Recurrent Disease

Ninety percent of symptomatic HSV-2 infections and 60% of HSV-1 infections recur within 1 year. Patients usually experience 5-8 recurrences per year, but some may have outbreaks as frequently as every 2-3 weeks. The frequency and number of recurrences are highly variable.

Recurrent lesions usually arise at the site of the primary infection. Over time, the recurrences become less frequent.

Reported precipitating events for

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