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DIAGNOSIS And MANAGEMENT Of

HERPES SIMPLEX

presented by:
Riffatyani Arsyad
Ratna Nur Aisyah

C111 11 113
C111 11 327

Advisor :

dr. Fauzan Azhari Marzuki

Supervisor :
Dr. dr. Siswanto Wahab, Sp.KK

HERPES SIMPLEX
Introduction
Infection

with Herpes Simplex Virus (HSV)


is one of the most prevalent infections
worldwide
Once acquired mostly during infancy, the
virus persists lifelong in sensory local
ganglia and remains latent.
General appearance => vesicle,
eritematous

Definition
Herpes

simplex is an acute infection


caused by a virus which Herpes
simplex type 1 or 2

There

are two types of HSV: HSV-1 and


HSV-2.
HSV-1 is mostly associated with orofacial
disease
HSV-2 usually causes genital infection

eritematous
vesicle

Figure 1: Herpes Genital

Epidemiology
Seropositivity

to antibodies to HSV-2
is more common in women (25%)
than in men (17%)
In children less than 10 years of age,
herpetic infections are often
asymptomatic and of the HSV-1 type
(80-90%)
HSV-2 is the etiology of most genital
herpes infections (70-90%)

Etiology
HSV type 1
HSV type 2

Pathogenesis

Figure 2: Pathogenesis Human Herpes Virus

Clinical Symtoms
Primary Infection

Orolabial Herpes
Orolabial herpes associated with HSV-1 infection

Figure 3: Orolabial herpes

Genital Herpes
Genital herpes caused by HSV-2

Figure 4: Genital herpes

Figure 5: Primary herpetic vulvitis

Whitlow Herpes
Whitlow herpes: digiti-genital contact

Figure 6: Herpetic Whitlow, classic group blister

Herpes Gladiatorum
Caused by HSV-1. Papular eruption and vesicle

Figure 7: Herpes gladiatorum , lesi HSV tipe 1 di leher

HSV Neonatus
Caused by HSV-2 infection from mother during birth
delivery

Figure 8: herpes neonatorum

Diagnosis
Anamnesis
Clinical Examinations
Supporting Examinations
Tzanck

Test

A giant, multinucleated keratinocyte on a


Giemsa-stained smearobtained from a vesicle
base.
Biopsy

epithelial cells are enlarged, swollen, and often separated.


Multinucleated cells with intranuclear eosinophilic inclusion
bodies can be seen.

Figure 9: Tzanck test positive in herpes simplex

Differential Diagnosis

Orolabial Herpes

Herpangina

Differential Diagnosis

Genital herpes

Ulcus Molle

Lhymphogranuloma
Venerum

Treatment Orofacial Herpes


Primary Infection

Treatment Genital Herpes


Primary Infection

Complication
Bacterial

and fungal infection

Balanitis
Candidiasis

vaginitis

Ocular

infection
Visceral infection
Central nervous system complication
Aseptic

meningitis
Ganglionitis and myelitis
Herpes simplex enchepalitis

Prognosis
Early

treatment gives a better


prognosis

Thank You