Infectious diseases. Herpes simplex. Etiology. Epidemiology. Pathology. Diagnostics. Treatment (most important)

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Infectious diseases. Herpes simplex. Etiology. Epidemiology. Pathology. Diagnostics. Treatment (most important)

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42. Herpes simplex. Etiology. Epidemiology. Pathology. Diagnostics. Treatment

Herpes simplex infection is clinically manifested by the defeat of many organs and tissues, accompanied by the appearance of clustered blisters on the skin and mucous membranes. It has a tendency to a long latent course with periodic relapses.

Etiology. Two types of virus (HVH-1 - most often cause damage to the skin of the face and mucous membranes of the oral cavity, HVH-2 - damage to the genitals, meningoencephalitis) differ in antigenic and biological properties.

Epidemiology. The source of infection are sick and virus carriers. Transmission is carried out by contact, sexual, airborne, a transplacental route of infection is possible, but infection occurs especially often during the passage of the birth canal.

Pathology. Pathological changes depend on the localization of the infection. On the skin and mucous membranes, the characteristic changes are the formation of vesicles resulting from stratification and ballooning degeneration of the cells of the spiny layer of the epidermis. Specific features include intranuclear inclusions - homogeneous masses located in the center of a significantly altered nucleus, the chromatin substance of which is displaced to the periphery, to its membrane.

With generalized forms, small foci of coagulation necrosis are formed in many organs and systems. In the central nervous system, changes occur in the cortical, less often in the white matter and subcortical centers. Typical diffuse vasculitis, glia proliferation, necrosis of individual nerve cells. Diagnostics. Diagnosis is based on two of the following:

1) typical clinical picture;

2) isolation of the herpes virus;

3) determination of specific neutralizing antibodies;

4) characteristic cells in prints or biopsy. Treatment. With localized lesions of the skin and mucous membranes, locally 0,25% oxolinic ointment, 0,5% Florenal ointment, 0,25-0,5% tebrofen ointment, 0,25-0,5% rhyodoxol ointment, as well as Acyclovir ointment and other antiviral drugs. With keratitis - the antiviral drug JDUR (5 iodine-2-deoxyuridine) in the form of ointments, solutions, as well as adenine arabinoside. The treatment of affected areas of the skin and mucous membranes is carried out using antiseptic agents: 1-2% alcohol solution of brilliant green, 1-3% alcohol solution of methylene blue, with herpetic stomatitis - 3% hydrogen peroxide solution. Locally used painkillers (anesthesia, lidocaine).

In severe forms of the disease, bonafton, local bonafton ointment, intravenous administration of YDUR, antiviral drugs (adenine arabinoside, highly active leukocyte interferon, acyclovir, virolex, ribavirin, etc.) are prescribed to prevent the progression of local manifestations and prevent dissemination of infection.

With a recurrent course of the disease, general strengthening and stimulating agents are indicated. Antibacterial therapy is carried out only with the layering of a secondary bacterial infection.

Author: Pavlova N.V.

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