Herpes simplex natural history, complications and prognosis
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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]
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
- Severe infection in immunocompromized
- Psychological distress
- Developmental delay
- Genital HSV can be fatal infections in babies.
- Increased susceptibility to HIV infections
- Damaged adrenals
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
- ↑ 1.0 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.
- ↑ 2.0 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.
- ↑ Template:Corey, Lawrence, et al. "Genital herpes simplex virus infections: clinical manifestations, course, and complications." Annals of internal medicine 98.6 (1983): 958-972.