Herpes Simplex Virus Type 1
Herpes Simplex Virus Type 1
Objectives
By the end of these revision notes, you should:
What is Herpes Simplex Virus Type 1?
The herpesvirus has a four-layered structure. They contain a core with double-stranded DNA. This is enclosed by a capsid made of capsomers. The capsid is surrounded by an amorphous protein coat known as the tegument. The outermost layer is a lipid bilayer envelope which has glycoproteins – these allow the virus to bind to cells.
The herpes simplex virus type 1 (also known as HSV-1, human herpesvirus 1 or HHV-1) is responsible primarily for oral infections. These are both primary and secondary infections.
Primary Herpetic Stomatitis
Primary herpetic stomatitis is the primary infection of HSV-1. This is incredibly common with 99% of cases either subclinical or asymptomatic. Majority of patients who present with a clinical infection are younger than the age of 6.
Clinical Features
- Incubation period of 7-10 days.
- Clinical duration of 7-10 days (may be longer with malaise, particularly in adults).
- Typically affects the hard palate, gingivae and dorsum of the tongue.
- Vesicles develop that are dome-shaped and tense. They are filled with clear fluid and may be up to 3mm in diameter.
- Patients may develop up to 100 vesicles.
- Vesicles rupture after 1-2 days and form extensive, shallow ulcers. Ulcers may enlarge and coalesce.
- Patients may also experience malaise, pyrexia and lymphadenopathy. They also struggle with eating/drinking due to the pain.
Diagnosis
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