DEPARTMENT OF DERMATOVENEREOLOGY

MEDICAL FACULTY
HASANUDDIN UNIVERSITY

REFERAT
JULY

HERPES SIMPLEX

Andi Batari Toja C11107181

Nelasari P. Horansil C11110115
Anggun Setyawati C11110117
Advisor:
dr. Suci Nugraeni
Supervisor:
dr. Safruddin Amin, Sp. KK(K), MARS
PRESENTING AS A TASK ON CLERKSHIP
DEPARTMENT OF DERMATOVENEREOLOGY
MEDICAL FACULTY HASANUDDIN UNIVERSITY
MAKASSAR
2014

DEFINITION
Herpes simplex is an acute infection
caused by herpes simplex virus (or
herpes hominis virus) type I or type
II which is characterized by the
presence of clustered vesicles over
the swollen skin and erythematous
on
the
area
near
the
mucocutaneous, while the infection
can take place both primary and
recurrent.

EPIDEMIOLOGY

Transmission of HSV-1 continues in the world.

Ocular infection with HSV-1 become the major cause

of blindness worldwide.

> 530 million people worldwide are infected with

HSV-2

Herpes affects approximately 30-60% of women who

are pregnant, with a high susceptibility to the
occurrence of neonatal herpes & severe herpes.
Transmission from mother to fetus is about 85%;

ETIOLOGY

HSV-1 and HSV-2 are members of

the Herpesviridae family, a group of
lipid-enveloped double-stranded DNA
viruses. Both serotypes of HSV are
members of the -Herpesviridae
virus
subfamily.
-Herpesviruses
infect multiple cell types in culture,
grow rapidly, and efficiently destroy
the host cells.

ETIOLOGY (cont..)

The spread and transmission of the

virus among humans occurs through
physical contact and is generally
caused
by
the
presence
of
mucocutaneous lesions. Oral and
ocular lesions primarily caused by
HSV-1 and HSV genital lesions by-2

PATHOGENESIS

DIAGNOSE - History Taking

Ask about patient's sexual habits or another

possiblity history of contact.
Symptoms such as malaise usually obtained,
which is very painful ulcers usually felt 2-3
weeks if not treated.
In homosexual patients, lesions are also present
in the perianal region and around rectum area.
In women, the same lesions found on the
external genitalia and mucosal areas of the
vulva, vagina, and cervix.

DIAGNOSE - Clinical Findings

Orolabial Herpes
Orolabial herpes is virtually always caused by
HSV-1. In 1% or less of newly infected persons,
herpetic gingivostomatitis develops, chiefly in
children & young adults.
The onset is often accompanied by high fever,
regional lymphadenopathy, and malaise. The
herpetic lesions in the mouth are usually
broken vesicles that appear as erosions
or
ulcers covered with a white membrane.

DIAGNOSE - Clinical Findings

Primary herpetic gingivostomatitis

DIAGNOSE - Clinical Findings

Genital Herpes
Clinical findings of acute first-episode genital
herpes among patients with HSV-1 and HSV-2 is
almost the same. Infections associated with
genital lesions in different stages of evolution,
in the form of vesicles, pustules, and ulcers
erythematosus. These lesions are associated
with pain, itching, dysuria, vaginal discharge,
and lymphadenopathy.

DIAGNOSE - Clinical Findings

A. Primary genital herpes with vesicles.

B. Primary herpetic vulvitis.

DIAGNOSE - Clinical Findings

Herpetic Keratoconjunctivitis
Herpetic keratoconjunctivitis is herpes simplex
that infected on eye. It occurs as a punctate or
marginal keratitis, or as a dendritic corneal
ulcer, which may cause disciform keratitis and
leave scars that impair vision until blindness.

DIAGNOSE - Clinical Findings

Herpetic Keratoconjunctivitis
70% of cases of neonatal herpes simplex are
caused by HSV-2. The clinical spectrum of
perinatally acquired neonatal herpes can be
divided into three forms: 1) localized infection
of the skin,
eyes and/or mouth (SEM); 2)
central nervous system (CNS) disease; and 3)
disseminated disease (encephalitis, hepatitis,
pneumonia, and coagulopathy).

DIAGNOSE - Clinical Findings

Neonatal herpes, on the scalp of neonate.

DIAGNOSE Laboratory
Findings

DIAGNOSE Laboratory
Findings

DIFFERENTIAL DIAGNOSIS

Primary Syphilis
Caused
pallidum

by

Treponema

that

is

usually

sexually transmitted.
The chancre starts as a dusky
red macule a papule a
round-to-oval

ulcer;

called

ulcus durum (hard ulcer),

raised

borders

that

are

indurated, with the clean base

DIFFERENTIAL DIAGNOSIS

Chancroid
A sexually transmitted acute
ulcerative
caused

disease
by

which

is

Haemophilus

ducreyi.
The chancre begins as a soft
papule
erythema

surrounded

by

pustular,

then

eroded ulcerated; and its

base

is

composed

of

DIFFERENTIAL DIAGNOSIS

Limfogranuloma venereum
Systemic sexually transmitted
disease caused by L serovars of
Chlamydia trachomatis.
3-30 days after infection, 5- to
8-mm

painless

erythematous

papule(s) or small herpetiform

ulcers appear at the site of
inoculation. Painful ulcerations &
nonspecific urethritis are less

TREATMENT
RECOMMENDED REGIMENS FOR THE TREATMENT
OF OROFACIAL HERPES SIMPEX INFECTION

TREATMENT
RECOMMENDED REGIMENS FOR THE TREATMENT
OF GENITAL HERPES SIMPEX INFECTION

TREATMENT
RECOMMENDED REGIMENS FOR THE TREATMENT
OF OCULAR HERPES SIMPEX INFECTION

COMPLICATION

PROGNOSIS
Early treatment will give a better prognosis, which
are the onset and the recurrency more less even.
Patient with immunocompromised status e.g with
RES

tumor,

the

longer

immunosupressan

treatment can cause this infection spread to vital

organ and final to death.