Pathophysiology
1) disease state caused by infection with one of two different viruses (HSV-1, HSV-2) 2) infection causes a lifetime latency, which can intermittently reactivate 3) virus invades nerve endings and travels to ganglia where it becomes dormant – when reactivated, virus travels back down nerve to periphery and reinfects epithelial cells 4) secondary infection is usually less severe or even asymptomatic but shedding can occur
Histology/Gross Pathology
1) Cowdry type A bodies 2) linear double-stranded DNA with envelope glycoproteins that allow penetration into cells
Associated Conditions
1) increased incidence in – AIDS, transplant recipients, neutropenic patients, burns, eczema ) in oropharyngeal herpes bacterial superinfection occurs
Biochemistry
can be reactivated by emotional stress, trauma, menstruation, fever, and UV light
Inheritance/Epidemiology
1) infection is via contact with mucosa or via cracks in stratum corneum of skin 2) genital herpes is more easily transmitted from men to women 3) type 1 is mostly transmitted via infected oral secretions or lesion (herpes labialis) and type 2 is mostly transmitted sexually (genital herpes) 4) 20% of adults in USA are infected with genital herpes (3 times more common in blacks than in whites)
Treatment
1) IV acyclovir if systemic or severe infection 2) if localized, famciclovir or valacyclovir is given
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