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HERPES SIMPLEX VIRUS

Presented by: Iriabel Nepravishta

3rd January 2020

CASE STUDY (fictional)

  • A 55-year-old diabetic patient known to have chronic kidney disease is present for clinical follow-up.
  • The patient presented the following symptoms:

Fever

Dyspnea

Aphasia

Disorientation

The patient was also in a fugue state.

Lowry, Robin (LR) - I would take the sections from the rubric and bullet them here. You are missing some of the content: Have HPI: then PMH: (include allergies here) then Physcial findings: then Labs: That way it is very clear and it meets the rubric.

Lowry, Robin (LR) - See if you can arrange it so the titles of your slides are CASE STUDY (you already have), Disease Discription, and Medication Management

Lowry, Robin (LR) - After reviewing the slides, I do not see how the information connect to the fictiious case study. Maybe give the patient a name: Mrs B or Mr S. and then refere to the patient to the content links to patient assessment and care. Just a thought.

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TEST RESULTS.

  • White blood cell count of 14,630/ml
  • C-reactive protein- 1.2 mg/dl
  • This was unusual considering the normal range 0–0.5 mg/dl Remove and include in your narrative
  • The patient was given broad-spectrum antibiotic therapy while awaiting the CSF culture results.

Shorten to: Broad-spectrum antibiotic therapy and include rest in narrative

  • Although the CSF culture result was –ve, viral DNA similar to HSV was detected in the fluid.

remove the words and just have the results CSF fluid –ve; + DNA similar to HSV.

Lowry, Robin (LR) - See comments in red. when doing a ppt presentation, you want to capture the key concepts in the bullets but fill in the meaning with the narrative. That way the audience is focused on what you are saying not trying to read the ppt.

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INTRODUCTION

  • The term “herpes” is a Greek word meaning “to creep”.
  • HSV belong to the ever-present Heresviridae family.
  • As revealed by McElwee et al (2018) human HSV causes contagious infection.
  • HSV is often associated with:

Orofacial infections

Inflammation of the brain.

  • Genital infections is often caused by HSV-2

Lowry, Robin (LR) - again this is a little wordy stick to the 7x7 rule: no more than 7 lines with no more than 7 words per line.

  • HSV-2 can be transmitted from infected mothers to a new born child.
  • Near or at point of entry into the both viruses causes lesions.

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HISTORY

  • According to research HSV can cause:

Primary or reactivation infections.

  • As earlier mentioned both viruses are implicated in:

Genital

Orofacial infections.

  • Contact and sexual intercourse are mainly associated with infections.
  • As explained by Rahn et al (2017 ) the clinical proceedings depends on:
  • The age factor.
  • Immune status of the host
  • The antigenic virus type & the anatomic site of involvement.
  • Primary infection in both viruses are normally accompanied by systemic signs, prolonged symptoms together with high rate of complications.
  • On the contrary recurrent infections are milder and shorter.

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EPIDEMIOLOGY &TRANSMISSION.

  • HSV-associated diseases infections affect approximately 60-95% of human adults (Rahn et al., 2017 ).
  • Mostly affects children 6 months to 3 years of age.
  • No animal reservoirs.
  • Over 75% of persons tend to acquire type one antibodies by adulthood.
  • It’s significant to note that primary infection by HSV-2 commonly affect young adults.
  • Overly transmission is due to contact with lesions on mucosal.
  • HSV-1 is commonly spread by contact-kissing.
  • HSV-1 often affects skin above the waist.
  • HSV-2 is transmitted sexually.
  • It can also be transmitted from a maternal genital during birth of a new born.
  • HSV-2 typically infects skin below the waist.

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SIGNS & SYMPTOMS

  • Itching
  • Genital herpes
  • Blistering sores

In some cases, one can experience symptoms similar to the flue:

Fever

Tiredness

Lack of appetite

Headaches

Swollen lymph nodes.

  • It should be mentioned that one may not have visible sores and still be infected.
  • When HSV spread to the eyes this causes a condition called keratitis.
  • In this symptoms may include eye pain or discharge.

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CLINICAL SIGNIFICANCE.

  • HSV-1

Herpetic whitlow

Acute gingivostomatitis

Cold sores

Encephalitis

  • HSV-2

Genital herpes

Neonatal herpes

LAB DIAGNOSIS.

  • Cytopathology.

According to Bradshaw & Venkatesan (2016) this a technique that examines cells.

The goal is usually to determine the cause of disease.

  • Isolation & identification

  • Polymerase chain reaction

  • Serology
  • Serology- This is diagnostic examination of blood serum.
  • Serology often detect or measure the levels of antibodies.

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TREATMENT & PREVENTION

  • Herpes simplex is incurable.
  • As such treatment focuses on:
  • Controlling outbreaks.
  • Curing sores. (In some case sores go away without medication).
  • Sores may go away with without treatment.
  • Nonetheless following medications are often prescribed:

Acyclovir

Famciclovir

Valacyclovir

These medications aid in reducing the risks of transmission.

They also help lower the intensity of outbreaks.

It should be mentioned that medications may come in oral or applied as a cream.

Medications may also be administered by injection.

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POSSIBLE COMPLICATIONS.

  • Neonatal HSV is fatal about 25% of the time.
  • Infection can spread to other parts of the body.
  • This happens when the infected person touches the lesion as well as other part of the body.
  • When it involves the eyes, it is very serious.
  • Anyone experiencing an outbreak of HSV must take a few preventative steps:
  • Avoid oral sex or kissing
  • Avoid physical contact
  • Don’t share items like cups or clothing.

Pregnant mothers may have to take medication to prevent the virus from infecting unborn children.

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REFERENCES

  • McElwee, M., Vijayakrishnan, S., Rixon, F., & Bhella, D. (2018). Structure of the herpes simplex virus portal-vertex. PLoS biology, 16(6), e2006191.
  • Rahn, E., Thier, K., Petermann, P., Rübsam, M., Staeheli, P., Iden, S., ... & Knebel-Mörsdorf, D. (2017). Epithelial barriers in murine skin during herpes simplex virus 1 infection: the role of tight junction formation. Journal of Investigative Dermatology, 137(4), 884-893.
  • Bradshaw, M. J., & Venkatesan, A. (2016). Herpes simplex virus-1 encephalitis in adults: pathophysiology, diagnosis, and management. Neurotherapeutics, 13(3), 493-508.

Questions.

What is the main genetic feature that best describe the herpes virus family?

Circular dsDNA genome

Segmented DNA genome

Large linear DNA genome

Small ssDNA genome

2. Which among the choices are characteristics of the herpes virus family?

Can cause no disease

Can cause cancer

Can establish virus latency in the host

Can reactivate and cause disease for life

Conti….

  • 3. Identify which among the choices is a disease not caused by herpes viruses.

Infertile paralysis

Cancer

Encephalitis

Sexually transmitted disease

4. How are herpes infection managed?

Vaccines

No method

Chemotherapy

Hygiene & social distancing.

  • Identify the morphology of the herpes virion.

Small round virus

Baggy virion with over 50 types of spikes

Compact icosahedron structure

Complex with a membrane and tegument and icosahedron core.

THE END.

  • Questions?