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.
 Genitalherpes 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