Herpetic infection — the chronic recurrent infection caused by a virus of simple herpes and which is characterized by primary defeat of integumentary fabrics and nervous cages. The main way of transfer of a herpetic infection contact, but airborne and transplacentary transfer of a virus is possible. Distinctive feature of a herpetic infection is ability of viruses is long to persistirovat in nervous gangliya. It leads to emergence of a recurrence of herpes during the periods of decrease in protective forces of an organism. Genital herpes, visceral herpes, generalized herpes, herpetic stomatitis and conjunctivitis belong to displays of a herpetic infection herpes .
Herpetic infection — the chronic recurrent infection caused by a virus of simple herpes and which is characterized by primary defeat of integumentary fabrics and nervous cages. Now distinguish two types of a virus of simple herpes. The I type of a virus mainly affects mucous membranes and integuments of a mouth, a nose, eyes, is transferred in mainly contact and household way, the II type causes genital herpes, is transferred mainly sexually. The tank and a source of a herpetic infection is the person: carrier or patient. Allocation of the activator can continue very long time.
The transfer mechanism – contact, a virus is allocated for the surface of the affected mucous membranes and integuments. Besides the main ways of transfer for the I type of a virus can be also implemented airborne, air and dust, and the type II can vertically be transferred from mother to the child (transplatsentarno and intranatalno). The viruses which got into an organism are inclined to long preservation (mainly in cages ), causing an infection recurrence during the periods of weakening of protective forces of an organism (colds, avitaminosis). More often primary infection proceeds latentno, the disease is shown later, the sharp infection is noted only at 10-20% which caught.
The herpetic infection is classified by primary defeat of these or those fabrics: herpes of skin, mucous membrane of a mouth, eye, SARS, genital herpes, visceral herpes, herpetic defeat of nervous system, herpes of newborns, generalized form.
Symptoms of a herpetic infection
The incubatory period of a herpetic infection usually makes 2-12 days, the beginning can be both sharp, and gradual, often primary infection remains unnoticed by the patient at all, the course of a disease becomes recidivous. A recurrence can arise as 2-3 times a year, and is extremely rare – 1-2 times in 10 years and less often. A recurrence is inclined to develop against the background of immunity easing therefore quite often clinical displays of herpes accompany a SARS, pneumonia, other sharp infections.
Herpetic damages of skin are localized mainly on lips and wings of a nose. At first the itch and burning in the localized area of skin is subjectively felt, then this area is condensed, on it the vesicles filled with the transparent contents which are gradually growing turbid are formed. Bubbles are opened, leaving behind the superficial erosion, crusts which are beginning to live in several days without consequences. Sometimes through the damaged covers bacterial flora gets, causing secondary suppuration and complicating healing. Regionarny lymphadenitis can be noted (knots are increased, slightly painful). The general symptomatology is not observed, or the disease proceeds against the background of other infections causing additional clinic.
Herpetic damages of a mucous membrane of a mouth it is characterized by developing of sharp or recurrent stomatitis. The disease can be followed by the phenomena of the general intoxication, fever. The mucous membrane of a mouth becomes covered by groups of the small vesicles filled with transparent contents, which are quickly opened and leaving painful erosion. Erosion in a mouth can heal up to 2 weeks. The disease can proceed in the form of aftozny stomatitis (there is a formation – the single, slowly healing erosion of a mucous membrane of an oral cavity). At the same time the general clinical manifestations (intoxication, a hyperthermia), as a rule, are absent. Herpetic stomatitis is inclined to a retsidivirovaniye.
Herpes as a SARS quite often proceeds without characteristic vesiculate rashes on mucous and skin, reminding other respiratory viral diseases on clinic. In rare instances herpetic vesicular rash is formed on almonds and a back wall of a throat (herpangina).
Genital herpes is usually shown as local rashes (vesicles are mainly formed on a head of a penis and the internal surface of extreme flesh at men and on big and small vulvar lips at women), and the general signs (fever, intoxication, regionarny lymphadenitis). Patients can note pain in the bottom of a stomach and in a waist, in places of localization of rash - burning and an itch.
Rashes at genital herpes can progress, extending on mucous vaginas and a neck of a uterus, an urethra. Chronic genital herpes can become the uterus neck cancer reason. In many cases genital rashes are accompanied by herpes of mucous membranes of a mouth and eyes.
Oftalmogerpes is shown by a rash on a cornea, in the subsequent causes formation of ulcer defects, decrease in sensitivity of a cornea that promotes deterioration in sight. Herpes of back departments of an eyeball meets seldom. Chronic recurrent herpes of an eye can lead to permanent turbidity of a cornea, a blindness.
The herpetic infection of nervous system proceeds as serous meningitis (it is expressed as the general and meningealny symptomatology, proceeds it is good-quality), or encephalitis (the expressed intoxication, fever reaches extremely high figures, the convulsive symptom, various paresis, paralyzes and disorders of consciousness is noted). Herpetic encephalitis in 30% of cases leads to a lethal outcome, after treatment leaves serious consequences in the form of persistent paralyzes and paresis, dementia.
Visceral forms of herpes proceed according to clinic of inflammatory diseases of the struck bodies. It can be herpetic pneumonia, hepatitises, pancreatitis, nephrites, ezofagita, herpes of adrenal glands. At herpetic defeat of the hollow bodies available to endoscopy, on a mucous membrane vesicular rashes and erosion can be noted.
At newborns and patients with the expressed immune insufficiency the generalized form of a herpetic infection which is characterized by high prevalence of skin manifestations, damages of mucous membranes and internals against the background of the general intoxication and fever can develop. The generalized form at patients AIDS quite often proceeds in the form of gerpetiformny eczema of Kaposha.
One of forms of a herpetic infection is shingles. The beginning of a disease is quite often preceded by the prodromalny phenomena – a general malaise, headaches, rise in temperature to subfebrilny figures, dispepsichesky symptoms. Burning and an itch in the field of a projection of peripheral nervous trunks can be noted. The Prodromalny period proceeds from one day to 3-4 days, can differ in various intensity of signs depending on a condition of an organism of the patient. In many cases the sharp beginning is noted: temperature sharply rises to febrilny figures, the general intoxication is noted, gerpetiformny rashes on skin on the course of an innervation spinal develop.
Process can extend within one or several nervous trunks. Most often rashes are localized along a projection of intercostal nerves or branches of a trigeminal nerve on a face, damage of extremities, genitals is less often noted. Rashes represent the groups of vesicles with serous contents which are settling down on sites of the hyperemic condensed skin. In a zone of rashes burning, intensive pains of vegetative character is noted. Pains arise pristupoobrazno, more often at night. Disorders of tactile sensitivity in a zone of an innervation of the affected nerves, radicular paresis of facial and glazodvigatelny nerves, a sphincter of a bladder, muscles of a belly wall and extremities can be noted. Fever is noted for several days then abates, together with it intoxication symptomatology disappears.
The abortive form of the surrounding herpetic infection proceeds in the form of short-term papular rash without formation of vesicles. At a bullous form herpetic vesicles merge, forming large bubbles – bulls. The bullous form quite often can progress in bullous and hemorrhagic when contents of bulls gain hemorrhagic character. In certain cases bulls merge on the course of nervous fiber, forming the uniform bubble, extended in the form of a tape, leaving a dark necrotic scab after opening.
Weight of a course of shingles depends on localization of defeat and a condition of protective forces of an organism. Especially hard proceeds deprive in the field of an innervation of nerves of the person and the head, at the same time eyelids, an eye cornea often are surprised. Duration of a current can make of several days (an abortive form), up to 2-3 weeks, in certain cases dragging on for a period of up to a month and more. After transferring of shingles a recurrence of a herpetic infection in such form is celebrated quite seldom.
Diagnosis of a herpetic infection
Diagnosis of a herpetic infection is carried out by means of the virologic analysis of contents of vesicles and scrape of erosion. Besides, the activator can be allocated from blood, urine, saliva, sperm, washouts from a nasopharynx, a likvor. In case of posthumous diagnostics of the activator allocate from bioptat of fabrics. Allocation of a virus of simple herpes does not give sufficient diagnostic data on activity of process.
It is possible to carry to additional techniques of diagnosing RNIF of dabs prints (huge multinuclear cages with Koudri's inclusions type A come to light), RSK, RN, IFA in pair serums. Research of immunoglobulins: increase of a caption of immunoglobulins M speaks about primary defeat, and immunoglobulin G – about a recurrence. Recently the extended method of diagnosis of a herpetic infection is PTsR (polymerase chain reaction).
Treatment of a herpetic infection
A variety of clinical forms of a herpetic infection causes a wide range of experts who are engaged in its treatment. Treatment of genital herpes is carried out by venereologists, women have gynecologists. Neurologists are engaged in treatment of a herpetic infection of nervous system. Tactics of treatment of a herpetic infection is chosen depending on a clinical form and the course of a disease. It is possible to carry an acyclovir, other antiviral medicines to etiotropny therapy. In mild cases apply local treatment (ointments with an acyclovir, Burov's liquid). Glyukokortikosteroidny ointments are contraindicated.
The general treatment by antiviral medicines is appointed courses, at primary herpes - up to 10 days, chronic recurrent herpes is the indication to long-term treatment (about one year). Generalized, visceral forms, herpes of nervous system treat by means of intravenous administration of antiviral medicines, it is desirable to begin a course of treatment in the earliest terms, duration it makes usually 10 days.
At chastoretsidiviruyushchy herpes the immunostimulating therapy for remission is recommended. Immunomodulators, adaptogens, immunoglobulins, vaccination, the intravenous laser radiation of blood (ILRB) are appointed. The physical therapy is widely used: Ural federal district, infrared radiation, magnetotherapy, KVCh, etc.
Forecast and prevention of a herpetic infection
The herpetic infection with damage of the central nervous system (herpetic encephalitis has high risk of a lethal outcome, after it there are heavy permanent frustration of an innervation and work of TsNS), and also herpes at the persons suffering AIDS has the adverse forecast. Herpes of a cornea of an eye can promote development of a blindness, uterus neck herpes – to cancer. The surrounding herpes quite often leaves behind various disorders of sensitivity, neuralgia for some time.
Prevention of herpes like I corresponds to general measures of the prevention of respiratory diseases, herpes like II – prevention of diseases, sexually transmitted. Secondary prevention of a recurrence of herpes consists in the immunostimulating therapy and specific vaccination the inactivated herpetic vaccine.