Herpes simplex natural history, complications and prognosis: Difference between revisions

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{{Herpes Simplex}}
{{Herpes Simplex}}


{{CMG}}; {{AE}} {{CZ}}
{{CMG}}; {{AE}} {{CZ}}, {{USAMA}}
==Overview==
==Overview==
[[Pregnant]] women who have an active herpes infection on their genitals or in their birth canal when they deliver may pass the [[infection]] to their newborn infant. The risk of passing the [[infection]] to the baby is highest if the mom first becomes infected with herpes during [[pregnancy]]. Babies of women who become infected during pregnancy are at risk for [[premature]] birth. The baby may develop brain infection ([[meningitis]], [[encephalitis]]) , chronic [[skin]] infeciton, severe developmental delays, or [[death]]. The risk for severe [[infection]] in the baby is lower in recurrent outbreaks, with the highest risk in women experiencing an outbreak at the time of delivery. Women with a history of herpes but who only have occasional or no outbreaks rarely transmit the infection to their babies.
If left untreated herpes simplex can become recurrent. [[Neonatal]] herpes infection is a rapidly progressive disease resulting in [[CNS]] disease and disseminated disease. Clinical presentation of herpes initially include vesicular [[skin rash]]. Early diagnosis and treatment with [[acyclovir]] prevents the progression of disease. If left untreated the infection can rarely  progress to involve the [[CNS]] and other organ systems. Involvement of CNS presents with irritability, confusion and [[respiratory difficulty]]. Disseminated disease may result in rare cases. [[CNS]] disease can have residual neurological deficits. Other complications include [[pneumonia]], [[esophagitis]], [[encephalitis]], premature birth, spontaneous abortion and death of the infant. Babies can have developmental delay and death.<ref name="pmid11483781">{{cite journal |vauthors=Kimberlin DW, Lin CY, Jacobs RF, Powell DA, Frenkel LM, Gruber WC, Rathore M, Bradley JS, Diaz PS, Kumar M, Arvin AM, Gutierrez K, Shelton M, Weiner LB, Sleasman JW, de Sierra TM, Soong SJ, Kiell J, Lakeman FD, Whitley RJ |title=Natural history of neonatal herpes simplex virus infections in the acyclovir era |journal=Pediatrics |volume=108 |issue=2 |pages=223–9 |year=2001 |pmid=11483781 |doi= |url=}}</ref>The prognosis is good for herpes skin infections in immunocompetent individuals. The use of [[acyclovir]] has reduced mortality in [[CNS]] and disseminated disease but the overall prognosis is poor in immunocompromized and infants.<ref name="pmid3392410">{{cite journal |vauthors=Whitley RJ, Corey L, Arvin A, Lakeman FD, Sumaya CV, Wright PF, Dunkle LM, Steele RW, Soong SJ, Nahmias AJ |title=Changing presentation of herpes simplex virus infection in neonates |journal=J. Infect. Dis. |volume=158 |issue=1 |pages=109–16 |year=1988 |pmid=3392410 |doi= |url=}}</ref>
 


==Natural History==
==Natural History==

Revision as of 15:26, 7 June 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Usama Talib, BSc, MD [3]

Overview

If left untreated herpes simplex can become recurrent. Neonatal herpes infection is a rapidly progressive disease resulting in CNS disease and disseminated disease. Clinical presentation of herpes initially include vesicular skin rash. Early diagnosis and treatment with acyclovir prevents the progression of disease. If left untreated the infection can rarely progress to involve the CNS and other organ systems. Involvement of CNS presents with irritability, confusion and respiratory difficulty. Disseminated disease may result in rare cases. CNS disease can have residual neurological deficits. Other complications include pneumonia, esophagitis, encephalitis, premature birth, spontaneous abortion and death of the infant. Babies can have developmental delay and death.[1]The prognosis is good for herpes skin infections in immunocompetent individuals. The use of acyclovir has reduced mortality in CNS and disseminated disease but the overall prognosis is poor in immunocompromized and infants.[2]

Natural History

If left untreated herpes simplex can become recurrent. Neonatal herpes infection is a rapidly progressive disease resulting in CNS disease and disseminated disease. Clinical presentation of herpes initially include vesicular skin rash. Early diagnosis and treatment with acyclovir prevents the progression of disease. If left untreated the infection can rarely progress to involve the CNS and other organ systems. Involvement of CNS presents with irritability, confusion and respiratory difficulty. Disseminated disease may result in rare cases. CNS disease can have residual neurological deficits. Babies can have developmental delay and death.[1]

Complications

Individuals with HIV or other immunocompromized patients are at a higher risk of complications of HIV. The complications of herpes simplex infection include: [3]

  • Recurrent painful genital sores
  • Psychological distress
  • Developmental delay

Prognosis

  • The prognosis is good for herpes skin infections in immunocompetent individuals.
  • The use of acyclovir has reduced mortality in CNS and disseminated disease but the overall prognosis is poor in immunocompromized and infants.[2]

References

  1. 1.0 1.1 Kimberlin DW, Lin CY, Jacobs RF, Powell DA, Frenkel LM, Gruber WC, Rathore M, Bradley JS, Diaz PS, Kumar M, Arvin AM, Gutierrez K, Shelton M, Weiner LB, Sleasman JW, de Sierra TM, Soong SJ, Kiell J, Lakeman FD, Whitley RJ (2001). "Natural history of neonatal herpes simplex virus infections in the acyclovir era". Pediatrics. 108 (2): 223–9. PMID 11483781.
  2. 2.0 2.1 Whitley RJ, Corey L, Arvin A, Lakeman FD, Sumaya CV, Wright PF, Dunkle LM, Steele RW, Soong SJ, Nahmias AJ (1988). "Changing presentation of herpes simplex virus infection in neonates". J. Infect. Dis. 158 (1): 109–16. PMID 3392410.
  3. Template:Corey, Lawrence, et al. "Genital herpes simplex virus infections: clinical manifestations, course, and complications." Annals of internal medicine 98.6 (1983): 958-972.

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