A process called Auto inoculation HSV can sometimes involve the trunk extremities or head a pattern that’s common among wrestlers because they have a lot of skin-to-skin contact and is therefore called herpes gladiatorial. Finally individuals with burn injuries or with atopic dermatitis can have really serious herpes infections in those areas, the latter even has a specific name, eczema herpetic on HSV can also affect the eye causing keratoconjunctivitis which is inflammation of both the cornea and the conjunctiva in addition to the symptoms of conjunctivitis which are pain, redness, tearing and sensitivity to light. There can be some classic signs of corneal involvement like blurry vision and a branching dendritic lesion which looks a bit like the dendrites of a neuron which happens on the cornea itself and this pattern is classic for herpes infection.

In rare cases herpes viruses can spread to the central nervous system and cause meningitis or encephalitis typically affecting the temporal lobe in individuals of all ages. These can happen from a primary infection but more commonly happened during reactivation when some of the virus can escape into the bloodstream, when there is brain involvement, a lumbar puncture often has specific findings like an increase in red blood cells and increase in white blood cells and elevated protein levels there are also some CTE, MRI and EEG changes that can help to make a diagnosis. HSV can also pass from a mother to a baby rather than causing a congenital infection while the fetuses is in the Uterus. Most of the transmission happens at Birth when the baby passes through the infected maternal vaginal secretions during delivery neonatal. HSV causes three different patterns of illness, each happening about one third at the time, the first is skin or mucous membrane infection where lesions pop up one to two weeks after delivery typically at sites of damaged skin like the site where fetal scalp electrodes might have been attached. The second is central nervous system infection which typically causes lethargy, irritability and even seizures two to three weeks after delivery and can cause some of the same lumbar puncture CT, MRI and EEG findings as that in older children and adults with HSV encephalitis.

If not treated, both the first and second type in transition into the third type which is disseminated infection where herpes virus causes sepsis and failure of various organs including the heart and the brain, HSV can cause unique symptoms in immunocompromised individuals who tend to have more frequent reactivation. More severe symptoms and a wider range of symptoms like lesions in the esophagus or lungs, herpes can usually be diagnosed based on how the skin or mucous membrane lesions look and can be confirmed with tests looking for viral DNA like polymerase chain reaction. An antibody response to the virus or by growing the virus with a viral culture, although infections typically resolve without treatment within a couple of weeks….there are antiviral drugs like acyclovir, Pham Cyclovia and Vala cycle of ear that can be used topically or systemically to reduce pain and speed up healing for recurring episodes. These treatments usually work best if taken when the prodrome starts in other words before the blisters develop and high-dose intravenous antivirals might be given in more severe or life-threatening situations. So as a quick recap, most the time herpes simplex virus 1 and 2 cause asymptomatic latent infections that’s set up in the trigeminal and sacral ganglia for life but sometimes they can cause symptoms like recurrent oral and genital lesions, they can also cause more severe infections like HSV keratoconjunctivitis meningitis and encephalitis as well as neonatal infections which usually get transmitted when a baby passes through infected vaginal secretions.

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