Herpes Simplex

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A viral infection transmitted by direct contact, and characterised by a localised primary lesion, latency, and recurrence. Lesions can be oral (lips, oral mucosae) or genital.

Cause

  • Herpes simplex virus types 1 and 2

Clinical features

TYPE OF HERPES

FEATURES

Herpes simplex: Primary infection
  • May be asymptomatic
  • In some cases, there may be fever, malaise, gingivostomatitis, and vesicular lesions in the oropharynx
  • Generalised cutaneous eruptions
  • If genital infection, painful vescicular eruption in the genital area
  • Meningoencephalitis and chronic eczema may be a complication

Herpes simplex Reactivation of primary infection
  • Recurrent Herpes labialis and genitalis
  • Severe in the immunosuppressed

Differential diagnosis

  • Aphthous ulcer
  • Other causes of genital sores, e.g. syphilis
  • Other causes of meningoencephalitis

Investigations

  • No routine investigation necessary. Diagnosis is clinical

ManagementTreatment

Symptomatic treatment

  • Clean lesions with antiseptic, e.g. chlorhexidine solution 0.05%
  • Or diluted hydrogen peroxide solution 6%
  • In severe or extensive infection, acyclovir 400 mg every 8 hours by mouth for 7 days
    • Child: 100-200 mg 5 times a day for 5-7 days

Note: Acyclovir only works if it is started within 48 hours of the first symptoms

Prevention

Provide health education on

  • Personal hygiene
  • Avoiding direct contact with infected people
  • Use of gloves and condoms as applicable