HERPES SIMPLEX

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

Differential diagnosis

  • Aphthous ulcer
  • Other causes of genital sores, e.g. syphilis
  • Other causes of meningoencephalitis
  • Investigations
  • No routine investigation necessary. Diagnosis is clinical

MANAGEMENT
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
  • PreventionProvide health education on
  • Personal hygiene
  • Avoiding direct contact with infected people
  • Use of gloves and condoms as applicable
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