The diagnosis and Clinical Feature of Herpes

Herpes outbreaks can be diagnosed by culturing the virus obtained from a lesion or by measuring the serum antibody titers (a laboratory test that measures the presence and amount of antibodies in blood). Your body starts to produce special “soldiers” called antibodies for each specific organism it encounters.

This specific antibody is then measured and rises during the first infection. Both the culturing in the laboratory of the virus and the measuring of the serum antibodies are important to confirm the clinical diagnosis especially during pregnancy as is discussed under the heading “Herpes and Pregnancy“.

The diagnosis is usually from the patient history, symptoms the person presents with and a clinical examination that the doctor performs.

What are the clinical features that characterize Herpes Simplex virus?

Remember that the Herpes outbreak Simplex Virus is a commonly occurring DNA virus and can cause several non-specific symptoms and illness. A vast number of people have serum antibodies to Herpes Simplex, indicating that at some time they have encountered an infection from this virus.

Whilst in the average person it causes local infection and then repeated infection, in people with low immunity, it can cause serious infection and even death.

Primary infection

The most common feature of a primary infection of Herpes outbreaks. Type 1 (HSV-1) especially seen in children is an acute inflammation of the gum and mouth. This is accompanied by malaise, headache, fevers and enlarged lymph glands of the neck. The lesions start as tiny blisters called vesicles and turn into ulcers that can be seen scattered all over the lips and mucous membranes of the mouth. This infection usually lasts for 14 days.

HSV-2 outbreak is a primary infection which is present in the genital or peri-anal (occurring around the anus) areas. It is usually transmitted by sexual intercourse and the blisters enlarger rapidly and ulcerate.

Recurrent infections:

These usually occur in the same place every time as the virus stays in a specific nerve root. Recurrent bouts are usually triggered by one of several factors:

  • During upper respiratory tract infections like the common cold hence the term “cold sores”
  • Being run-down
  • Exposure to sunlight. The UVR (Ultra violet ray) component that seems to “activate/irritate” the virus
  • Menstruation
  • Stress
  • Other viral or bacterial infections
  • After surgery
  • Poor diet
  • Surgical trauma
  • After intercourse when there is mucosal abrasion

The recurrent episode starts with tingling, burning or even pain and within a few hours redness develops followed by the tiny blister (vesicles) which enlarge and fill with pus. It starts to rupture and crust within 1-2 days and heals within 10-14 days.

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