HERPES

SIMPLEX VIRUS
Group 4
 HERPES SIMPLEX VIRUS
HERPES SIMPLEX VIRUS (HSV-1 or HSV-2) INFECTION
- causes herpes
- a recurrent viral infection
- can cause painful lesions in the genital area
- lesions may also develop in cervix

HSV-1: primarily causes oral herpes

HSV-2: primarily causes genital herpes
HSV-1
HSV-2
HERPES VIRUS INFECTION
 Causative agent:
 Incubation Period
 Period of Communicability
 Mode of transmission
 immunity
CAUSES OF HSV1
-Herpes simplex type 1, which is transmitted through oral
secretions or sores on the skin, can be spread through 
kissing or sharing objects such as toothbrushes or eating
utensils.
 SIGNS AND SYMPTOMS OF
HSV1
 Symptoms of oral herpes include
-painful blisters or open sores called ulcers in or around the mouth
-Sores on the lips are commonly referred to as “cold sores.”
Infected persons will often experience a tingling, itching or burning
sensation around their mouth, before the appearance of sores.
After initial infection, the blisters or ulcers can periodically recur. The
frequency of recurrences varies from person to person.
 Genital herpes caused by HSV-1 can be asymptomatic or
can have mild symptoms that go unrecognized. When
symptoms do occur, genital herpes is characterized by 1 or
more genital or anal blisters or ulcers. After an initial
genital herpes episode, which may be severe, symptoms
may recur, but genital herpes caused by HSV-1 often does
not recur frequently.
HSV2
 HSV-2 infection is widespread throughout the world and is
almost exclusively sexually transmitted, causing genital
herpes. HSV-2 is the main cause of genital herpes, which
can also be caused by herpes simplex virus type 1 (HSV-
1). Infection with HSV-2 is lifelong and incurable.
CAUSES OF HSV2
-In general, a person can only get herpes type 2 infection
during sexual contact with someone who has a genital
HSV-2 infection. It is important to know that both HSV-1
and HSV-2 can be spread even if sores are not present.
TYPE 1 :
WHAT IS GINGIVOSTOMATITIS?
 Gingivostomatitis is a contagious mouth
infection that causes painful sores, blisters, and
swelling.
 It usually spreads through the saliva of an
infected individual or by direct contact with a
lesion or sore.
 Gingivostomatitis is most common in young
children, usually under 6 years old, but can also
occur in adults. Older people may experience
more severe symptoms.
 Gingivostomatitis is sometimes called herpetic
stomatitis.
SIGNS AND SYMPTOMS

Symptoms of gingivostomatitis can vary in

seriousness. You may feel minor discomfort, or
experience severe pain and mouth tenderness.
Symptoms of gingivostomatitis may include:
 tender sores on the gums or insides of cheeks (like
canker sores, they are grayish or yellow on the
outside and red in the center)
 bad breath
 fever
CONT.
 swollen, bleeding gums
 swollen lymph nodes
 drooling, especially in young children
 a general feeling of being unwell (malaise)
 difficulty eating or drinking due to mouth discomfort, and
in children a refusal to eat or drink
TYPE 2 HERPES
(GENITAL WARTS)
SIGNS AND SYMPTOMS

 Common symptoms of some types of HPV are warts,

especially genital warts.

 Genital warts may appear as a small bump, cluster of

bumps, or stem-like protrusions. They commonly affect
the vulva in women, or possibly the cervix, and the penis
or scrotum in men. They may also appear around the anus
and in the groin.
SIGNS AND SYMPTOMS
 Common warts – rough, raised bumps most commonly found on the hands,
fingers, and elbows.

 Plantar warts – described as hard, grainy growths on the feet; they most
commonly appear on the heels or balls of the feet.

 Flat warts – generally affect children, adolescents, and young adults; they
appear as flat-topped, slightly raised lesions that are darker than normal skin
color and are most commonly found on the face, neck, or areas that have
been scratched.
SIGNS AND SYMPTOMS

 painful sores in the genital area, anus, buttocks, or thighs.

 itching.
 painful urination.
 vaginal discharge.
 tender lumps in the groin.
CLINICAL MANIFESTATIONS
 Common manifestations of some types of HPV are warts,
especially genital warts. Genital warts may appear as a
small bump, cluster of bumps, or stem-like protrusions.
They commonly affect the vulva in women, or possibly the
cervix, and the penis or scrotum in men. They may also
appear around the anus and in the groin.
MEDICAL MANAGEMENT
 REDUCE MANIFESTATION
-GENITAL HERPES IS A CHRONIC DISEASE WITHOUT A CURE
 MANAGEMENT FOCUSES ON PREVENTING OR LESSENING OCCURRENCE AND
GIVING PALLIATIVE CARE

 MEDICATIONS:
-ACYCLOVIR AND VALACYCLOVIR
ASSESSMENT FINDINGS
 Blisters on any part of the mouth accompanied by erythema and
edema
 Fever
 Swelling of the lymph nodes under the jaw
 Appetite loss
 Increased salivation
 Conjunctivitis (herpetic keratoconjunctivitis, or herpes of the
eye)
ASSESSMENT FINDINGS

GENITAL HERPES
 Fluid-filled blisters
 Painful urination
 Fever
 Swollen lymph nodes
DIAGNOSIS
 Typical lesions may suggest HVH infection.
Confirmation requires isolation of the virus from
local lesions in specialized culture tubes. As the
lesions are often pathognomonic and frequently
painful, a biopsy is rarely necessary. A rise in
antibodies and moderate leukocytosis may support
the diagnosis, although such testing is not
generally required for diagnosis
DIAGNOSTIC EVALUATION
Confirmation requires isolation of the virus from
local lesions and histologic biopsy
Blood studies reveal a rise in antibodies and
moderate leukocytosis.
PCR test: The PCR test can tell if you have genital
herpes even if you don't have symptoms. The PCR test
looks for pieces of the virus's DNA in a sample taken
from cells or fluids from a genital sore or the urinary
tract. This is a commonly used test to diagnose genital
herpes and is very accurate.

Cell culture: During the exam, your health care

provider can take a sample of cells from a sore and
look for the herpes simplex virus (HSV) under a
microscope.
Cell culture or PCR test may give a false-
negative result if the sores have begun healing
or if you are recently infected. A false-negative
test shows you don't have the condition when in
fact you do. False-positive test results are
possible, too. If you test positive, but your risk
for getting the virus is low, you may
need further testing.
NURSING DIAGNOSES
 Acute pain related to presence of localized inflammation
and open lesions
 Impaired social interaction related to acquired condition
PLANNING AND GOALS
The client will express feeling of comfort and pain
relief
The client will exhibit improved or healed lesions or
wounds
The client will resume effective communication
patterns
IMPLEMENTATION
 Observe standard precautions. For clients with extensive
cutaneous, oral, or genital lesions, institute contact
precautions to prevent the spread of infection.
 Administer pain medications and prescribed antiviral
agents as ordered to relieve pain and to treat infections.
IMPLEMENTATION
 Provide supportive care, as indicated, such as oral hygiene,
nutritional supplementation, and antipyretics for fever.
This measures enhance the clients well-being.
 Abstain from direct client care if you have herpetic
whitlow (an HVH finger infection which commonly
affects health care workers) to prevent the spread of
infection.
THERAPEUTIC MANAGEMENT
 Antiviral chemotherapy (cyclovir) is prescribed to reduce
symptoms and shorten the duration of he lesions.
Acyclovir may be given during late pregnancy to a woman
with recurrent outbreak to reduce the possibility that she
will have active lesions at time of birth.
THERAPEUTIC MANAGEMENT
 Vaginal delivery is allowed if there are no genital lesions at
the time of delivery.
 Cesarean birth is recommended for women with active
lesions in genital area.
 TREATMENT
 Symptomatic and supportive treatment
Drug therapy options
 Analgesic-Antipyretic agent: acetaminophen to reduce fever and
relieve pain
 Drying agent: calamine lotion to relieve pain of genital lesions
 Antiviral agent: idoxuridine, trifluridine, vibradine, acyclovir
ointment (possible relief to clients with genital herpes or to
immunosuppressed clients with HVH skin infections; I.V. acyclovir
to treat more severe infections)
NURSING MANAGEMENT
 Prevent Infection
 When the vesicles of HSV ruptures, they release a highly
contagious exudate. Clients and health care providers should
wash their hands thoroughly after any contact with herpetic
lesions.
 Infected clients should have their personal items separated.
 USE CONDOM
PROVIDE SUPPORT
 Support groups may help clients deal with anger, guilt and
shame.

 REDUCE PAIN
 Keeping the involved area clean and dry
 Wearing loose-fitting, non-synthetic undergarments.
 Sitz bath, cooling applications and analgesics medication
EVALUATION
 The client reports adequate pain control
 The client displays healing lesions
 The client reports improved social interaction
GROUP B STREPTOCOCCUS
 Group B Strep bacteria can cause infection in a pregnant
woman and her baby.

 Found normally in the intestine, vagina, and rectum.

BACTERIAL PROFILE
 Causative agent: Streptococcus agalactiae