Herpetic infection
A group of infectious diseases caused by the herpes simplex virus, which are characterized by predominant damage to the skin, mucous membranes, central nervous system and a chronic relapsing course. Distributed everywhere. 90% of adults are infected with the herpes simplex virus (HSV), and clinical manifestations are observed in almost 20% of the population.
Due to the increase in disorders in the immune system, there is a tendency to increase the incidence of various forms of herpes infection. Damage to the central nervous system by the herpes virus, severe forms of herpes infection in children can cause death, eye damage can lead to loss of vision.
Etiology, pathogenesis.
HSV is large, contains double-stranded DNA, and has a complex structure. There are 2 main variants of the virus - HSV1 and HSV2. The source of the virus is patients with clinically pronounced forms of herpes infection and healthy virus carriers.
Infection occurs through direct contact through kissing (mainly HSV1), sexual intercourse (HSV2); by airborne droplets - when droplets of saliva containing the virus enter the mucous membrane of the respiratory tract; through household items, toys. If a woman in labor has genital herpes, infection may occur during childbirth. Infection with HSV1 occurs in childhood, HSV2 - upon reaching puberty, and the frequency of infection with HSV2 clearly correlates with sexual activity.
Susceptibility to HSV is universal. The virus penetrates through mucous membranes and damaged skin into epithelial cells, which is accompanied by characteristic local changes. After the death of the affected cells, the virus is not eliminated from the body, but penetrates the nerve ganglia, where it remains in a latent state for a long time.
Relapses of herpes infection are associated with immunogenetic characteristics of the body, infectious diseases, stressful situations, nutritional disorders, hypothermia, excessive insolation, menstruation (lead to weakening of immune control).
Symptoms, course. Clinical manifestations of herpetic infection are varied.
There are congenital and acquired herpes infections. With congenital herpetic infection, depending on the timing of infection of the fetus, abortion, stillbirth, the presence of malformations, and the birth of a child with signs of a generalized infection are possible. Acquired infection can be primary or recurrent.
Based on localization, herpetic lesions of the skin, mucous membranes, central nervous system and internal organs are distinguished; they can be localized, widespread and generalized. For primary herpes infection, the incubation period ranges from 2 to 14 days. Herpetic skin lesions are characterized by burning, itching, and pain. After a few hours, local hyperemia and swelling of the skin appear, then small grouped bubbles with transparent contents, which become cloudy after 1-2 days. After opening the vesicle, erosion forms, covered with a yellowish crust, which then disappears without leaving scars. The most common localization is lips, corners of the mouth, wings of the nose, ears, and less commonly other areas of the skin.
With localized rashes, the general condition is not disturbed; with widespread ones, short-term fever, headache, myalgia, arthralgia, and weakness are observed. Herpetic stomatitis is most often observed in children 2-3 years old. It begins acutely with an increase in body temperature to 39-40°C and intoxication. At the same time, increased salivation appears. Bubbles filled with clear liquid appear on the mucous membrane of the lips, cheeks, gums, tongue, soft and hard palate, palatine arches and tonsils. After 2-3 days they open and painful erosions form. The total duration of the disease is up to 2 weeks.
Ophthalmic herpes can be isolated or combined with lesions of the skin of the face or oral mucosa. There are photophobia, pain in the eyes, tears