Infectious Disease

Herpes Simplex Virus Infection

Herpes simplex virus causes recurrent painful mucocutaneous lesions and can also cause sight-threatening keratitis, encephalitis, eczema herpeticum, neonatal disease and disseminated infection; management depends on site, severity, host, pregnancy and timing.

Definition

Herpes simplex virus infection is infection with HSV-1 or HSV-2, which establish lifelong latency in sensory ganglia and cause recurrent mucocutaneous vesicles and ulcers. Infection can also involve the cornea, brain, skin over eczema, neonate or immunocompromised host, where it becomes an urgent systemic disease.

First principles

Latency makes infection lifelong

After mucocutaneous infection, HSV travels along sensory nerves to a trigeminal or dorsal-root ganglion and remains latent. Reactivation can produce symptomatic lesions or asymptomatic shedding in the same sensory territory, so antivirals suppress replication and symptoms but do not eradicate the virus.

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