What is recurrent herpes simplex

As we all know, herpes, as the name suggests, is the growth of herpes in certain parts of the human body. The main symptoms are: local skin itching, redness, swelling and pain, small bumps, and herpes is easy to infect and spread. Therefore, many people suffer from frequent recurrences of herpes, which is a headache. Recurrent herpes simplex refers to the local skin first becoming red and itchy, followed by the appearance of blisters, which is also a type of herpes.

Clinical manifestations and diagnosis of recurrent herpes simplex can be divided into three types. Currently, it is believed that there are two effective drugs for systemic herpes simplex virus infection, one is adenosine and the other is acyclovir. Theoretically, interferon may also be effective, but there are still no reports on its clinical application.

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Clinical manifestations and diagnosis Clinical manifestations can be divided into three types:

① Systemic disseminated type: mainly invasion of internal organs, manifested as hepatitis (elevated serum transaminase and/or jaundice, hepatosplenomegaly). Pneumonia (dyspnea, cyanosis), disseminated intravascular coagulation (purpura, thrombocytopenia, hematuria, bloody stools), pericarditis, circulatory failure and symptoms of systemic poisoning (mental depression, poor breastfeeding, vomiting, diarrhea, convulsions, coma), etc. This type may or may not be complicated by herpes encephalitis. Skin and mucous membrane blisters are also dispensable;

② Central nervous system infection type: often manifested as meningoencephalitis (coma, convulsions, pathological reflexes, papilledema, bulging fontanelles, etc., and cerebrospinal fluid often shows changes of viral infection). This type may or may not be accompanied by skin and mucous membrane herpes;

③Herpes simplex type: Herpes simplex only appears on the skin, eyes or mouth. The location of herpes is sometimes related to the presenting part during delivery. For cephalic presentation, it is often on the head; for breech presentation, it is often on the buttocks and around the anus. The lesions are the same as those in adults and may occasionally turn into pustules and bullae. The rash may peel off rapidly, making diagnosis difficult.

Among the three types, type ① and ② are more common, and these two types can account for more than 3/4 of the total. The case fatality rates were 80% and 30% respectively. Survivors also often have severe central nervous system and, less commonly, eye damage.

It is easier to diagnose if the mother has herpes in the birth canal or is positive for herpes simplex virus. It is not difficult to diagnose patients who have typical herpes lesions on the skin and mucous membranes after the onset of the disease. However, confirmation must also be confirmed by virology and serology. For patients without rash or with very atypical rash, the main reliance is on virological and serological materials. If the virus isolation is positive and/or specific IgM antibodies appear in the neonatal blood, or general anti-HSV antibodies increase by more than 4 times during the course of the disease, it can assist in diagnosis.

HSV infection of the central nervous system is difficult to diagnose when presenting alone. In the past, temporal lobe brain tissue was often used for virus isolation or specific antigen detection. Although cerebrospinal fluid isolation of virus or specific antigen detection can also confirm the diagnosis, the positive rate is too low, probably because the amount of virus is too small. Since 1990, some people have used the PCR (polymerase chain reaction) method to amplify viral nucleic acids in cerebrospinal fluid and then hybridize them with specific probes. The results showed that all four cases of herpes simplex encephalitis confirmed by brain biopsy or autopsy were positive, and all six controls were negative. Later, some people reported the application of nested polymerase chain reaction (nestPCR), which was believed to be able to further improve the sensitivity and was worthy of further trial.