HERPES SIMPLEX

&
MOLLUSCUM
CONTAGIOSUM

SHAVEEN E V
24TH BATCH
Medical
College,Thrissur
India
 HERPES SIMPLEX VIRUS HSV-1& HSV-2

 INFECIONS-----MUCOCUTANEOUS
 CNS
 &
 VISCERAL
 AGENT– ds DNA;LIUEAR STRAND
 PATHOGENESIS
 ENTRY& MULTI IN
SENSORY/A,NOMIC
DERMIS &
NERVE ENDINGS,,
EPIDERMIS INTRA AXONALLY THRU
CELL BODIES TO
GANGLIA

CENTRIFUGAL
MIGRATION
 MODE OF SPREAD
EXPLAINS….
1. LARGE SURF AREA
2. HIGH FREQUENCY OF LESIONS
3. DISTANCE 4M INITIAL
 IMMUNITY

 ANTIBODY & CELL MEDIATED

 CMI MOR IMP THAN ANTIBODY
 CD8+ T CELL REQ 4 CLEARANCE OF
LESION
 EPIDEMIOLOGY
 HBV1 COMMON IN 90% OF ADULTS IN
5TH DECADE OF LIFE
 MOD OF TRANSMISSION
 HBV1—DIRECT CONTACT
 DROPLET SPREAD
 HBV2---VENERAL
 CLINICAL SPECTRUM
 GENERALLY
 HSV1—ABOVE WAIST
 HSV2---BELOW WAIST
 BUT CLINICALLY INDISTINGUISHABLE
WHETHER HSV 1 OR 2
 RECURRENCE—IS MORE TYPIFIED
 OROFACIAL
 GINGIVOSTOMATIS & PHARYNGITIS
 RE ACTIVATION—REC HERPES
LABIALIS
 CONST SYMPTOMS+CERVICAL
LYMPHADENOPATHY+INABILITY TO
EAT
 REACTIVATION OF HSV IN
TRIGEMINAL GANGLIA---SHEDDING IN
SALIVA…
Continue…
 HSV+ATOPIC ECZEMA=== KAPOSI’S
VARICELLIFORM ERUPTION
 CANDIDA—
 BELLS PALSY
 GENITAL INFECTIONS
 SPECIFIC—PAIN,ITCHING,DYSURIA
DISCHARGE,LYMPHADENOPATHY
 LESIONS---VESICLE,PUSTULE &
PAINFUL ERYTHMATOUS ULCERS
 VULVOVAGINITIS—CAN GO UP N UP
 BALANITIS– PROSTATITIS
 CLEAR MUCOID DISCHARGE N’
DYSURIA
 HERPETIC WHITLOW
 FINGERINFECTION
 EDEMA,ERYTHEMA N’ TENDERENESS
 EYE,CNS N VISCERAL
 CORNEAL BLINDNESS IN US
 RECURRENT– MOLLARET MENINGITIS
N’ ENCEPHALITIS
 ESOPHAGITIS
 DIAGNOSIS
 TZANC SMEAR– MULTINUCLEATE
GIANT CELL
 INTRANUCLEAR INCLUSION --
LIPSHUTZ BODIES
 BEST– DEMO HSV ANTIGEN BY PCR
 TREATMENT

 ACYCLOVIR—200 mg 5 times/day
 FAMCYCLOVIR
 VALACYCLOVIR—BETTER BIOAVAIL N’
USED B/W SEXUAL PARTNERS
 ADV– RENAL INSUFFICIENCY
 RES—FOSCARNET
 CIDOFOVIR
MOLLUSCUM
CONTAGIOSUM
 AGENT N’ LESION
 POX VIRUS ,ds DNA
 MULTIPLE DOME SHAPED FIRM
ROUNDED PEARLY WHITE
UMBILICATED DISCRETE PAPULES
 2-5MM,DIMPLE IN CENTRE NO INFL N’
NECROSIS
 COMMON ON FACE N’HANDS
 GENITAL—SEXUAL TRANS
 AUTOINOCULATION
Continue…
 INVOLUTE IN 3-4 MONTHS
 INRACYTOPLASMIC IB—MOLLUSCUM
BODY[HENDERSON PATERSON]
 DIAGNOSIS-->DEMO OF VIRUS 4M D
LESION
 TREATMENT
 SCRAPIN AWAY,CURRETAGE
 FREEZIN BY ETHYL CHLORIDE
 CHEMICAL CAUTRISATION– CARBOLIC
ACID,TCAA,IOD TINCTURE
 NO SYS COMPLI/SKIN LESION 4 3-5
YEARS
 CIDOFOVIR—INVITRO IN
IMMUNOCOMPRISED…
 THANKS….
IN THE END….