Antiviral drugs for genital herpes

What is genital herpes? Genital herpes is an infection of the genitals (penis in men, vulva and vagina in women) and the surrounding skin area. It is caused by herpes simplex virus. Buttocks and anus may also be affected. Genital herpes is usually a sexually transmitted infection. Many people who are infected with this virus have no symptoms but can still spread the infection to others. If symptoms occur, they can vary from mild pain painful blisters on the genitals (vulva, vagina or penis) and the surrounding area. Antiviral drugs for genital herpes. If you have severe recurrences. This booklet discusses only antiviral drug for genital herpes. (See separate leaflet called genital herpes for more general details about genital herpes infection. ) What is an antiviral medicine?

Antiviral drugs are available to treat genital herpes include acyclovir, famciclovir and valaciclovir. They come in different brands. They work by stopping the herpes virus from multiplying. They do not eliminate the virus from the body. If an antiviral medication starts early in an episode of symptoms, which tends to reduce the severity and duration of symptoms during an episode of genital herpes. These drugs all work is thought as well as each other when used to treat genital herpes. Acyclovir is an older antiviral medication and has to be taken five times a day. Famciclovir and valaciclovir are newer and should only be taken three times daily antiviral medications. Antiviral drugs for a first episode of genital herpes An antiviral drug is commonly prescribed for a first episode of genital herpes. (A first episode of genital herpes is also called a first episode. ) A five-day course of treatment duration is usual, but this can be extended by a few days if blisters are still forming. With a first episode of genital herpes sores and blisters can last from 10 days to 20 days.

This is so very small overall if an antiviral medication is started within five days after the onset of symptoms. The sooner the drug, the best chance of symptoms acceleration starts. Antiviral drugs for recurrent episodes of genital herpes Other episodes of symptoms (relapses) tend to be milder and usually last a few days. Usually it has 7-10 days of symptoms rather than 10 to 20 days can be produced with a first episode. Antiviral drugs are often not needed for recurrences. Analgesics, salt baths, and local anesthetic ointment (such as lidocaine) for a few days may be enough to relieve symptoms. However, an antiviral drug may be advised by recurrent episodes of genital herpes in the following situations: If you have severe recurrences. If you take a five-day course of antiretroviral medication as soon as symptoms begin, you can reduce the duration and severity of symptoms. You may be prescribed a supply of medication at home to get ready to start as soon as symptoms begin. This type of intermittent treatment, which is only used when needed, tend to prescribe if you are getting severe attacks of genital herpes less than six times a year. If you have frequent recurrences.

You may be advised to take antiviral medication every day. In most people who take medication every day, recurrences are either stopped completely or their frequency and severity are significantly reduced. A lower maintenance dose rather than the full dose of treatment is usually prescribed. A typical plan is to take a 6 – to 12-month course of treatment. Then you can leave the medication to see if recurrences have become less frequent. This type of continuous treatment can be repeated if necessary. This type of daily treatment tends to be prescribed if you have severe attacks of genital herpes more than six times a year. For special events. A course of medication can help prevent a recurrence at special times. This may be an option, even if you do not have frequent recurrences, but I want to have the lowest risk of recurrence – for example, during the holidays or during exams. Antiviral drugs for genital herpes is while pregnant A specialist usually advise on what to do if genital herpes occur while you are pregnant, or if you have recurrent genital herpes and become pregnant. This is because there may be a possibility of transmitting the infection to her baby.

A first episode of genital herpes is while pregnant If you develop a first episode of genital herpes in the last six weeks of pregnancy, or around the time of birth, the risk of transmitting the virus to her baby is higher (there are about 1 April 10 opportunities). The baby may develop a serious infection of herpes if he or she is born vaginally. Therefore, in this situation may recommend that a caesarean is made to your specialist. This will greatly reduce the possibility that the baby comes in contact with the virus (mainly in blisters and sores around the genitals). Baby infection is then usually (but not always) prevented. However, if you decide against a caesarean section and decide to opt for a vaginal delivery, it is likely to recommend that given antiviral drugs (acyclovir usually) the specialist. It is administered intravenously (into a vein) during labor and birth. They may also suggest that antiviral medication can give your baby after birth. If you develop a first episode of herpes infection in the early stages of pregnancy, you run the risk of miscarriage. However, if you do not abort then there will be no harm to your baby. What is genital herpes? If you have frequent recurrences.

Whenever there are two months between catching the virus and give birth to her baby, it is likely to be safe for the baby of a normal vaginal delivery. This is because there will be time for antibodies to form and be transmitted to the baby to protect it when it is born. The specialist may advise that you should be treated with antiviral drugs at the time of infection. This helps the sores to clear quickly. In addition, some doctors recommend that you should take antiviral drugs in the last four weeks of pregnancy, in order to help prevent the recurrence of herpes at the time of delivery. However, this is not routine and the advantages and disadvantages of taking the antiviral medication within the last four weeks of pregnancy should be discussed with you by your specialist. If you have recurrent genital herpes and become pregnant If you have recurrent episodes of genital herpes, the risk to the baby is low. Even if you have an episode of blisters or sores during delivery, the risk of your baby developing severe herpes infection is low. This is due to pass in some antibodies and immunity to the baby during the last two months of pregnancy. However, there is some debate about what is better if you have a recurrent episode of sores or blisters during delivery. Some doctors may recommend a C-section. However, the National Institute for Health and Clinical Excellence (NICE) states that does not need a Caesarean section to be offered to women with a recurrence.

Also, the Royal College of Obstetricians and Gynaecologists (RCOG) is not routinely recommended a Caesarean if blisters or sores due to an episode of recurrent herpes at the time of delivery. Again, this is because it is likely to have some immunity to the virus and the possibility that the baby developing severe herpes infection is under the baby. If you have a recurrent episode when entering the work, you should discuss your options with your specialist and together decide the best way for your baby is born. Another moot point is whether the antiviral drug must be taken in the last four weeks before delivery. This can help prevent the recurrence of blisters during delivery. Again, the specialist will be able to advise on the pros and cons. In summary A first episode of herpes at the time of birth can be serious for the baby and cesarean section it is usually advisable. In any other situation – a previous primary infection or a history of recurrent episodes – the risk to the baby is low and your specialist will advise on possible options. Are there side effects of antiviral drugs? Most people taking antiviral drugs do not get side effects, or minor. Nausea, vomiting, diarrhea, and abdominal pain and skin rashes (including photosensitivity and itching) are the most common side effects. Read the leaflet inside the package of drugs for a complete list of possible side effects.

Using the yellow card system If you think you have had a side effect to one of your drugs you can be reported in Scheme yellow card. You can do this online at the following Web address: www. mhra. gov. uk / yellowcard. The yellow card is used to make Plan pharmacists, doctors and nurses know new side effects that drugs may have caused. If you wish to report a side effect, you will need to provide basic information about: The secondary effect. The name of the drug you think caused it. Information about the person who had the side effect. Your contact details as reporter side effect. This is useful if you have your medication – and / or leaflet that comes with it – with you while you complete the report.

Clinical manifestations in Virusinfektionen- Department of Virology

Organs, organ systems – Diseases, symptoms, syndromes Virusätiologie or stake (Remarks) Eye, surrounding structures Chlamydia trachomatis Dakryozystitis; canaliculitis; dacryoadenitis Coxsackie A viruses Herpes simplex virus (HSV) (Primärinf. ) Varicella zoster virus (VZV) Epstein-Barr virus (EBV) Mumps virus (acute and chronic)

Measles virus (acute) conjunctivitis, keratoconjunctivitis hemorrhagic conjunctivitis pharyngokonjunktivales fever Herpes simplex virus (HSV) (Primärinf. ) Varicella zoster virus (VZV) (Ophthalmic zoster) Adenoviruses (V. A. types 8, 19, 37): highly contagious (conjunctivitis epidemic! )

Chlamydia trachomatis Measles virus (Koplik spots conjunctival, sometimes purulent) influenza virus Parainfluenza viruses mumps virus Adenoviruses types 3, 4, 7, 14 Epstein-Barr virus (EBV) Molluscum contagiosum virus Vaccinia virus (papilla lacrimal) enterovirus 70 Coxsackievirus A24 (variant) Adenovirus type 11

(Rare: VHF excitation: hanta, yellow fever, Dengue, filoviruses et al) Adenoviruses types 3, 4, 7 and other adenoviruses Herpes simplex virus (HSV) Varicella zoster virus (VZV) measles virus mumps virus rubella virus Vaccinia virus (also necroric) Cataract (congenital) Rubella Virus (embryopathy) Cytomegalovirus (CMV)

Varicella zoster virus (VZV) congenital glaucoma Rubella Virus (Buphthalmus) retinitis acute necrotizing retinitis Cytomegalovirus (CMV) (with AIDS) human immunodeficiency viruses (HIV) Coxsackie A viruses Epstein-Barr virus mumps virus Rift Valley Fever virus Herpes simplex virus (HSV) Varicella zoster virus (VZV)

Eye muscle paralysis (ophthalmoplegia etc. ) Varicella zoster virus (VZV) Immunodefizienzviren human (HIV) Epstein-Barr virus (EBV) polioviruses rabies virus Musculoskeletal system, muscles Arthritis, arthralgia parvovirus B19 rubella virus Rubella virus (V. A.

in adult women) Mumps virus (V. A. in younger men) Dengue virus ( “break bone fever”) Varicella zoster virus (VZV) Hepatitis B virus (HBV) hantaviruses Yellow Fever Virus HTLV-I (esp. Shoulder) Poliovirus Type 1 – 3, other enteroviruses Rift Valley Fever virus

filoviruses Myalgia / myositis / Crohn Bornholm Enteroviruses: Coxsackie A virus types 1, 2, 4, 6, 9, 10, 16; Coxsackie B virus types 1-6; ECHO viruses hantaviruses influenza viruses human immunodeficiency viruses (HIV) Polioviruses types Displaying 1 – 36 Hepatitis A virus Yellow fever, dengue, filoviruses tropical spastic paraparesis (TSP, HTLV-associated myelopathy HAM called) HTLV-I, HTLV-II may Post-Polio Syndrome Poliovirus types 1, 2, 3 (formerly expired)

Blood and blood components, blood formation, immune organs parvovirus B19 Epstein-Barr virus (EBV) Leukopenia, lymphopenia measles enteroviruses human immunodeficiency viruses Yellow fever, dengue viruses Filoviruses (after leukocytosis) thrombocytopenia Cytomegalovirus (CMV) (in immune suppressed patients and connatally infected) Dengue, hantavirus, VHF viruses

pancytopenia Cytomegalovirus (CMV) Epstein-Barr virus (EBV) Parvovirus B19 (transient aplastic crisis in chronic hemolytic anemia) atypical mononuclear cells in the blood Epstein-Barr virus (EBV) (infectious mononucleosis, glandular fever) Cytomegalovirus (CMV) enteroviruses parvovirus B19 agglutinins Mycoplasma pneumoniae lymphadenopathy generalized predominantly

predominantly located human immunodeficiency viruses (HIV) HTLV Monkeypox virus, filoviruses Epstein-Barr virus (EBV) (cervical) Cytomegalovirus (CMV) Rubella Virus (nuchal) splenomegaly Epstein-Barr virus (EBV) Cytomegalovirus (CMV) mumps virus filoviruses immunosuppression

Cytomegalovirus (CMV) human immunodeficiency viruses (HIV) measles virus Leukemia, lymphoma: Adult T-cell leukemia (ATLL) Burkitt lymphoma, B-cell lymphomas intracerebral lymphoma Body cavity-based lymphoma, primary effusion lymphoma, Castleman’s disease HTLV-I Epstein-Barr virus (EBV) Epstein-Barr virus (EBV) (for HIV-Inf. ) human herpesvirus 8 (HHV-8, KSHV)

Coagulopathy, hemorrhage, hemorrhagic fever Dengue viruses (mostly secondary infection) Yellow Fever Virus Crimean-Congo hemorrhagic fever virus (CCHF) hantaviruses Rift Valley Fever virus (RVF) Lassa virus filoviruses gastrointestinal tract esophagitis Cytomegalovirus (CMV) (In immunosuppressed) Herpes simplex virus (HSV) (AIDS)

human immunodeficiency viruses (HIV) Adenovirus type 31 (immunosuppressed) Enteritis / colitis / diarrhea Rotavirus (infants, nosocomial) Adenovirus type 31 (immunosuppressed), types 1, 2, 5, 6 (toddlers), types 40, 41 (infants) Norwalkviren enteroviruses Coronaviruses (? ) measles virus Coxiella burnetii (Q fever) Hemorrhagic enteritis / colitis Cytomegalovirus (CMV) (immunosuppression)

VHF viruses: Crimean-Congo fever, Lassa, Rift Valley Fever, filoviruses Yellow fever, dengue viruses hantaviruses Invaginationsileus Adenoviruses types 1, 2, 5 (infants) Rotavirus vaccine, Herpes simplex virus type 2 (1) (HSV-2, -1) (with AIDS) Cytomegalovirus (CMV) (in immunosuppressed) liver Acute hepatitis / hepatomegaly Reye syndrome (encephalopathy and fatty liver degeneration in children) Hepatitis A virus (HAV) Hepatitis B virus (HBV)

Hepatitis C virus (HCV) Hepatitis D virus (HDV) Hepatitis E virus (HEV) Cytomegalovirus (CMV) (Plus splenomegaly; at connatally Infected or immunosuppressed) Epstein Barr virus (EBV) Adenoviruses (in immunosuppressed) Varicella zoster virus (VZV) Mumps virus (plus splenomegaly) Herpes simplex virus (HSV) (Mostly perinatal) parvovirus B19

Yellow Fever Virus Influenza viruses (V. A. after ASA administration) chronic hepatitis Hepatitis B virus (HBV) Hepatitis C virus (HCV) Hepatitis D virus (HDV) Cirrhosis, primary liver cell (hepatocellular) cancer = hepatoma Hepatitis B virus (HBV), chronic Hepatitis C virus (HCV), chronic Hepatitis D virus (HDV) hepatosplenomegaly

Coxiella burnetii (Q fever) pancreas pancreatitis mumps virus Cytomegalovirus (CMV) (with AIDS) Destruction of islet cells, thereby diabetes mellitus (type 1) mumps virus enteroviruses Rubella Virus (congenital infection) genitals prostatitis Herpes simplex virus type 2 (1) (HSV-2) Benign tumors of the genital mucosa (warts, condylomas)

Molluscum contagiosum-viruses Human papillomavirus types 6, 11, 42, 43, 44 and others ( “low-risk” types) Malignant tumors of the genital mucosa (intraepithelial neoplasia) Human papillomavirus types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 and others ( “high-risk” types) primary vesicular disease (later ulcerating) Herpes simplex virus type 2, rarer type 1 (HSV-2, -1) (genital herpes) Varicella zoster virus (VZV) (progenitaler zoster) genital infection Chlamydia trachomatis Orchitis / oophoritis (adnexitis) Mumps virus (with epididymitis) Vaccinia virus (unilateral) Sexually transmitted infections without local affection

(Symptoms, depending on the pathogen and stage) Hepatitis B virus (HBV) human immunodeficiency viruses (HIV) Cytomegalovirus (CMV) Hepatitis C virus (HCV) HTLV Marburg virus (convalescent phase! ) Skin and mucous membranes: localized, not vesicular lesions Molluscum contagiosum (giganteum) Molluscum contagiosum-virus Orfvirus human papillomavirus

Epidermodysplasia verruciformis (EV, precancerous, genetic) Human papillomavirus types 5, 8, 9 and others Keratoses (carcinoma in situ! ) Human papillomavirus types 2-4, 41 and other Kaposi’s sarcoma human herpesvirus 8 (HHV-8 = KSHV) T-cell lymphoma HTLV-I, HTLV-II (Mycosis fungoides? ) Skin and mucous membranes: localized, primary vesicular lesions herpes labialis Herpes simplex virus type 1 (2) (HSV-1)

genital herpes Herpes simplex virus type 2 (1) (HSV-2) eczema Herpeticatum Herpes simplex virus type 1 (2) (HSV-1) umbilicate vesicles chambered Vaccinia virus (laboratory staff! ) animal poxviruses Rashes under generalized viral infections: primarily macular lesions erythematous rash / Enantheme Parvovirus B19 (erythema infectiosum, “gloves and socks” syndrome) human herpes viruses 6, 7 (Exanthema Subitum) (HHV-6, -7)

measles virus Enteroviruses: Coxsackie A and B, ECHO rubella virus dengue virus human immunodeficiency viruses (HIV) (acute retroviral syndrome) filoviruses Rashes under generalized viral infections: primary vesicular lesions Hand, foot and mouth disease (mostly in children) Enteroviruses: Type 71, Coxsackie A and B viruses Herpangina (mostly in children) Enteroviruses: Coxsackie A viruses types 1 – 10, 16, 22, coxsackie B virus types 1-5, echovirus types 9, 11, 16 Vesicles generalized,

Varicella zoster virus (VZV) (varicella zoster rarely generalized satus in immunosuppressed) Herpes simplex virus type 1 (2) (in immunosuppressed) Monkeypox virus (monomorphic, often haemorrhagic) Other cutaneous manifestations in the context of generalized viral infections desquamation Measles virus (late stage) Filoviruses (recovering from illness) seborrheic dermatitis (cutis sicca) human immunodeficiency viruses (HIV) Petechiae / purpura, in extreme cases, ecchymosis Dengue, yellow fever virus Hepatitis C virus (HCV) VHF viruses: hanta, Filo-, Crimean-Congo hemorrhagic fever virus (CCHF)

Hepatitis B virus (rare) (HBV) see Hepatitis Heart and Vessels myocarditis Enteroviruses: Coxsackie A and B, ECHO, polio Influenza A viruses (in the course of the disease) mumps virus parvovirus B19 Epstein-Barr virus (EBV) adenoviruses hantaviruses TBE virus (Begleitmyokarditis) pericarditis

enteroviruses Lassa virus influenza viruses bradycardia filoviruses Yellow fever virus (with high fever = Farget characters) Congenital Heart Defects Rubella virus (acquired during pregnancy) vasculitis Hepatitis B virus (HBV) parvovirus B19 Atherosclerosis (hypothetical role) Cytomegalovirus (CMV)

Chlamydia pneumoniae hypertension Hantaviruses (stage of oliguria) Hantaviruses (shock stage) Rabies virus (extreme variations in blood pressure) Yellow fever virus (shock stage) all haemorrhagic fever viruses (shock stage) ears Inner ear defects (hearing) Cytomegalovirus (CMV) (intrauterine infection) Rubella Virus (congenital infection) Mumps virus (about standene infection) Lassa virus (about standene infection)

otitis media Influenza A viruses (in children) Parainfluenza viruses Respiratory Syncytial Virus (RSV) measles virus Enteroviruses (various) zoster oticus Varicella zoster virus (VZV) nose Rhinoviruses types 1-102 Coxsackie A viruses types 9, 10, 21, 24 Coxsackie B viruses types 1-5 ECHO viruses

Enterovirus 68, 71 coronaviruses Human respiratory syncytial virus (RSV) (mostly older children) Nose, paranasal sinus carcinoma Human papillomavirus type 57 Nasopharyngeal carcinoma (NPC) Epstein-Barr virus (EBV) Oral cavity, pharynx, neck measles virus filoviruses gingivostomatitis Herpes simplex virus type 1 (2) Coxsackie A virus

oral papillomas Human papillomavirus types 6, 11 (in HIV-infected types 7, 13 u. a. ) oropharyngeal carcinomas (tonsils) Human papillomavirus types 7, 11, 16, 33 tonsillitis Epstein-Barr virus (EBV) Cytomegalovirus (CMV) human immunodeficiency viruses (HIV) Mumps virus (mumps) Cytomegalovirus (CMV) enteroviruses

thyroiditis mumps virus nervous system Meningitis, meningitis irritation, meningism Enteroviruses: Coxsackie A and B, ECHO, polio enterovirus 71 mumps virus adenoviruses measles virus TBE virus Epstein-Barr virus (EBV) Herpes simplex virus type 2 (HSV-2) Sandfly fever virus (Tuscany / Naples / Sicily) hantaviruses

Japanese encephalitis virus (JEV) human immunodeficiency viruses (HIV) parvovirus B19 human herpes virus 6 (7? ) (HHV-6, -7) rubella virus dengue virus Rift Valley Fever virus Encephalitis, meningoencephalitis, encephalomyelitis (acute) Herpes simplex virus type 1 (2) (often with organic brain seizures) Varicella zoster virus (VZV) Cytomegalovirus (CMV) (immunosuppression, AIDS) TBE virus

measles virus enterovirus 71 human immunodeficiency virus (HIV) adenoviruses rabies virus Japanese encephalitis virus Polioviruses types 1-3 vaccinia Herpes B virus (monkey) HTLV Lassa virus chronic encephalitis, encephalopathy progressive panencephalitis

JC virus (progressive multifocal Leukoencephalopathy = PML in immunosuppressed) human immunodeficiency viruses (HIV) Prions (Jakob-Creutzfeld disease) Measles virus (SSPE) rubella virus Reye syndrome (encephalopathy and fatty liver degeneration in children) Influenza viruses (V. A. after ASA administration) myelitis transverse myelitis

poliomyelitis myelopathy TBE virus enteroviruses Epstein-Barr virus (EBV) human immunodeficiency viruses (HIV) filoviruses Cytomegalovirus (CMV) Varicella zoster virus (VZV) Herpes simplex virus type 2 (HSV-2) Enteroviruses, V. A. Poliovirus type 1, 2, 3

HTLV-I (tropical spastic paraparesis, TSP / HAM) Polyradiculoneuritis (Guillain-Barré syndrome, GBS), usually post-infectious after acute infections caused by: Cytomegalovirus (CMV) Epstein-Barr virus (EBV) Influenza A virus TBE virus human immunodeficiency viruses (HIV) mumps virus Herpes simplex viruses (HSV-1, -2) paresis: cranial nerves azialisparese / Hörsturz peripheral nerve

Polioviruses types 1-3 TBE virus human immunodeficiency viruses (HIV) Varicella zoster virus (VZV) mumps virus TBE virus human immunodeficiency viruses (HIV) HTLV-I (HTLV-II) Japanese encephalitis virus (JEV) Kidney, urinary tract, adrenal gland glomerulonephritis Hepatitis B virus (HBV) (in children) Hepatitis C virus (HCV)

nephritis acute renal failure, oliguria adenoviruses (Especially after renal transplantation) Cytomegalovirus (CMV) (Especially after renal transplantation) hantaviruses Lassa virus mumps virus Yellow Fever Virus filoviruses persistent infection of the kidney tissue Cytomegalovirus (CMV)

Adenoviruses type 35 (in immunosuppressed) Polyomavirus (BK, JC virus) Ureteral stenosis after renal transplantation BK virus (polyoma) urethritis Herpes simplex virus type 2 (1) (HSV-2) haemorrhagic cystitis adenoviruses BK virus (polyoma) (V. A. in immune suppressed) adrenalitis Cytomegalovirus (CMV) (in immunosuppressed)

Enteroviruses (perinatally acquired) filoviruses respiratory acute respiratory ( “flu”) infection ( “Common cold”) genuine virus flu Respiratory syncytial virus rhinoviruses enteroviruses coronaviruses Parainfluenza virus types 1-4 adenoviruses types Influenza viruses A, B, C seldom

Laryngitis (Croup) Human respiratory syncytial virus (RSV) Influenza viruses (in children) Parainfluenza viruses . Enteroviruses: v a coxsackie A virus type 9, Coxsackie B virus types 4, 5, ECHO viruses. pharyngitis Adenoviruses types 1-3, 5-7, 14 enteroviruses influenza viruses Parainfluenza viruses Human respiratory syncytial virus (RSV) hantaviruses

measles virus rubella virus TBE virus (initial stage) filoviruses Lassa virus Tracheitis, tracheobronchitis Influenza A viruses (haemorrhagic) Human respiratory syncytial virus (RSV) Parainfluenza virus type 1, 2 measles virus TBE virus Bronchitis, bronchiolitis Rhinoviruses (asthma attacks)

Human respiratory syncytial virus (RSV) Influenza A virus Influenza B viruses Parainfluenza viruses Enteroviruses: Coxsackie A and B, ECHO, enteroviruses 68-71 coronaviruses measles virus acute respiratory syndrome (ARDS) Hantaviruses (V. A. New World) Pneumonia, pneumonitis in adults

with children in immunosuppressed Influenza A viruses (primary / secondary) Influenza B viruses (rare) Adenoviruses types 4, 7 (military recruits) Human respiratory syncytial virus (RSV) Varicella zoster virus (VZV) Chlamydia pneumoniae Mycoplasma pneumoniae Coxiella burnetii (Q fever) Chlamydia psittaci Chlamydia trachomatis Human respiratory syncytial virus (RSV)

adenoviruses rhinoviruses Enteroviruses: V. A. Coxsackie A viruses Types 9, 16, 21, Coxsackie B viruses types 1-5, ECHO viruses, enteroviruses 68, 71 Parainfluenza viruses measles virus Chlamydia trachomatis (Perinatally acquired) Herpes simplex virus type 2 (1)

(HSV-2, -1) (perinatally acquired) Cytomegalovirus (CMV) (v. A. After bone marrow transplantation) adenoviruses Varicella zoster virus (VZV) Herpes simplex virus (HSV) Measles virus (giant cell pneumonia) Polyomavirus (BK) pleurodynia Coxsackie B viruses types 1-6 Coxsackie A viruses ECHO viruses

pregnancy Embryopathie, congenital malformations Rubella Virus (Gregg syndrome) Cytomegalovirus (CMV) Varicella zoster virus (VZV) human immunodeficiency virus type 1 (HIV-1) intrauterine injury, any miscarriage or premature birth hydrops Varicella zoster virus (VZV) Cytomegalovirus (CMV) Mumps virus (? )

enteroviruses Lassa virus filoviruses parvovirus B19 Hepatitis, hepatosplenomegaly the newborn Cytomegalovirus (CMV) Varicella zoster virus (VZV) Herpes simplex virus (HSV) (herpes neonatorum) Hepatitis B virus (HBV) Hepatitis C virus (HCV) Hepatitis E virus (HEV) severe systemic infection of the newborn (sepsis-like) Herpes simplex virus type 2 (HSV-2) (herpes neonatorum)

Varicella zoster virus (VZV) (congenital varicella) Enteroviruses (infection of the mother) vertical transmission human immunodeficiency viruses types 1, 2 (HIV-1, -2) Hepatitis B virus (HBV) Hepatitis C virus (HCV) Chlamydia trachomatis HTLV-I, -II Human papillomavirus (condyloma) vulnerability of expectant mother (severe course in pregnancy) Varicella zoster virus (VZV) (pneumonia) Hepatitis E virus (HEV) (fulminant hepatitis) Lassa virus

Shingles – Herpes Zoster

Shingles – Herpes Zoster Shingles – Herpes Zoster . . . Viral infection that causes pain, sensory disturbances and lesions in the coverage area of ​​a particular nerve. Synonym: Zoster Cause: The cause of shingles is a reactivation of the body of existing varicella zoster virus (Fig. Right). Shingles occurs only in people who were diagnosed in their childhood chickenpox. Incubation period (time between infection and outbreak): 7 to 21 days; seronegative may impair health in infection by a Zosterkranken chickenpox, but seropositive (ie previously undergone chickenpox) ill not obligate to shingles. Reinfection is the incubation period appears to be shorter (3 to 7 days? ).

Contagiousness (infectiousness): as with chickenpox ( “the wind fanned”) is very high Frequency: up to about 4 new cases per 1000 inhabitants per year Special hazards: the elderly, immunodeficiencies (z. B. AIDS or patients receiving immunosuppressive therapy, such as leukemia and tumors – also very dangerous complications possible – radiate therapierte patients among others, frequently even with systemic diseases such as diabetes mellitus or malignancy observed). One should therefore, if necessary, looking in all patients for a reason, which one comes after some expressed in the literature estimates at about 20% of people suffering from zoster to a significant underlying disease. Symptoms: small blisters on reddened skin that occur semi-bounded and are accompanied by pain and sensory disturbances, on the chest and abdomen often ring along certain of a nerve-supplied skin (segment), possibly even more segments, ie typically like a belt, whereupon the naming is based; but may also be the head or extremities (as often in the dispersion area of ​​a branch of the trigeminal nerve or on the leg in the dispersion area of ​​the sciatic nerve) spread more vertically. Initially, there are itching, however untreated course more and more turns into pain. The Allegemeinbefinden varies from hardly disturbed (possibly through pain) to fatigue and fever with severe malaise. Abortive courses with no or very small bubbles formation can occur occasionally. The infestation of mucous membranes and the swelling regional Lyphknoten is also possible. With the onset of crust formation, the pain subsides. Me After dropping the crusts like the chickenpox depigmented small skin scars.

Diagnosis: As with chickenpox the microbiological detection is difficult. The detection of elementary bodies by electron microscopy or the bacterial culture on human embryo cells is possible, but playing this method in practice no role. From the scrapings of fresh bubbles giant cells and Kerneinschlußkörper can lichtmekroskopisch indeed be detected, but again this is irrelevant, because the diagnosis can usually make reference to the situation described by the patient symptoms and by the typical lesions. Only in very extreme circumstances against other diseases you will fall back in some cases to the detection of antibodies in the serum. but Microbiological detection of pathogens in shingles could be necessary if the primary skin lesions by uncleanliness (esp. by scratching) are secondarily colonized with other bacteria (superinfection). Here, the microscopic or cultural detection of the pathogen should be sought. Clinic: The clinical course can best be dargestell to the typical skin symptoms: Fig. 1: 49-year-old patient, a few, z. T. scattered blisters, uncomplicated course Fig.

2: 65-year-old patient, distributed over several segments and a large area confluent vesicles groups, sometimes livid spots by lower circulation (warfarin therapy) Figure 3: The same patient as in figure 2 after 1 week of treatment with 5 x 800 mg acyclovir, residual crusts, yet distension, already visible depigmentation (scars) complications: Under bleeding (in very severe inflammation of the bubbles) = zoster haemorrhagicus ulcerative disintegration (in case of superinfection) = zoster gangraenosus Full infestation as chickenpox (esp. Immunosuppressed or elderly patients) = zoster generalized satus persistent nerve pain (often months) = post-zoster neuralgia The latter is but declined significantly since the introduction of antiviral therapy! Infestation of both halves of the body or more segments of a body half = zoster duplex or multiplex unilateralis Infestation of 1. Trigeminusastes involving the eye (Hornahaut u. Conjunctival) = ophthalmic zoster

Infestation of 2. Zervicalsegmentes with participation of the ear (hearing loss, facial nerve palsy, among others) = zoster oticus Involvement and inflammation of the brain (encephalitis), the meninges (meningitis) and spinal cord (myelitis) are possible and require fast and inpatient treatment. Prognosis: generally good, perilous is the zoster generalized satus, also forecast always determined by the simultaneous existence of a serious underlying disease. Therapy: treatment of choice is an antiviral drug acyclovir (Zovirax as ©) or brivudine (Zostex ©), possibly intravenously or as a short-term infusion in difficult cases (for example, immunosuppression); in case of non-response foscarnet (foscavir ©) as an infusion, dosage by age and weight Externally: zinc lotions, clioquinol soln. (Often no treatment required) Pain: all common painkillers bishin temporary therapy with opiates Superinfection: externally antibiotic on the pathogen or internally Zoster neuralgia: Pain Mitel and / or the anticonvulsant carbamazepine (Tegretal ©), alternatively amantadine (PK-Merz ©) In general, the treatment can be performed on an outpatient basis. Complicated courses should the clinic. In zoster opthalmicus or oticus can possibly be treated on an outpatient basis, but the competent specialist should be turned on.

Prophylaxis: No known! With the introduction of the chickenpox vaccine in childhood since 2004 possibly the shingles will decline in the future. Image sources: Fig . : varicella zoster virus (top) of Medicine Worlwide (http://www. m-ww. de/krankheiten/infektionskrankheiten/zoster. html) Fig. 1-3 are the property of the author. Created: 03. 12. 2004 / update: no / author: F. Wiegleb (fwiegleb@gmx.


Herpes in pregnancy – 8 questions ask your doctor

The herpes virus is particularly dangerous for the fetus, it is 50% of cases of intrauterine infection. What is the future mother of herpes infection knows? Let us try to answer the most important questions. 1. Why should I be tested for the herpes virus before pregnancy, is when you get rid of it still is not possible? 2. What is so dangerous herpes virus? 3. How to get the child? 4. What is herpes is the most dangerous for pregnant women, genital or plain? 5. What happens if a woman is already pregnant?

6. In pregnant women with herpes is almost no chance of a healthy baby? 7. Maybe help drugs that stimulate the immune system? 8. What about herpes on the lips? The fact that you need to prepare for pregnancy, know almost everything, but few do it correctly. According to statistics, 40% of women come to the gynecologist on the fact of pregnancy, considering that preventive intake of vitamins is enough to successfully create, perform and give birth to a healthy child. However, the planned examination of the spouses before conception to solve many problems, is caused in particular to intrauterine infection of the fetus by the herpes virus. 1. Why should I be tested for the herpes virus before pregnancy, if you are getting rid of it is still not possible? Indeed, it is impossible to cure the herpes infection, but no such problems and is not intended. The aim is to prepare the woman’s body, strengthen immunity, increases the body’s resistance and prevent the herpes virus activated in the decisive phase of childbearing.

2. What is so dangerous herpes virus? The disease herpes during pregnancy can lead to miscarriage, fetal malformations, especially microcephaly, microphthalmia, chorioretinitis. Child transmission can be full development spread of the infection, which flows from the liver, spleen, bleeding, pneumonia, encephalitis be, and in 90-95% of cases leads to death, when the baby is born too early especially. In mild cases of herpes infection leads to lesions of the skin and mucous membranes. 3. How to catch the baby? In 85% of cases of infection of the child occurs intrapartum, ie, during childbirth, when. Through the birth canal Interestingly, the virus from the mother is transmitted to the newborn, regardless of whether there is currently clinical manifestations of herpes in the genital area of ​​the woman or not, that is asymptomatic. The risk of infection increases in times of cervix and in the field of cervical and vulvar cancer has herpes if holiday is premature rupture of membranes, prolonged rupture of membranes preceded when doctors have to apply the tools of intervention at birth. Herpes can the newborn after birth in contact with the mother, cutaneous manifestations of infection are transmitted. 4. What is herpes is the most dangerous for pregnant women, genital or plain?

For a pregnant woman and the unborn child is the greatest risk of genital herpes, but not even the fact that his presence and his infection during pregnancy. Such cases lead to intrauterine infection of the fetus and have serious consequences. Therefore, for the herpes virus is not only a woman, but also their sexual partners should be checked, regardless of whether he signs of infection. As the statistics, only 20% of infected people have a confirmed diagnosis occurs 60% of the disease in an atypical form, 20% – in bessiptomnoy. In such cases, the virus can only be identified via assays. If a woman identified the partner herpes, but it is not a woman, it is important to prevent infection during pregnancy. 5. What to do if a woman is already pregnant? Tested for the herpes virus is necessary in any case. When it is detected, but no symptoms of the disease is not available, a treatment is needed. Later, carried out with the occurrence of herpes sores, the lo . . .