Related Subjects:
|Herpes Varicella-Zoster (Shingles) Infection
|Chickenpox Varicella Infection
|Varicella Cerebral Vasculopathy
|Herpes Viruses
|Herpes Zoster Ophthalmicus (HZO) Shingles
|MonkeyPox
|Mumps
|Measles
|Rubella (German Measles)
|Epstein-Barr Virus infection
|Cytomegalovirus (CMV) infections
|CMV retinitis infections
|Toxoplasmosis
🦠 Herpes Viruses (HHVs)
There are 8 known human herpesviruses (HHV-1 to HHV-8). They share the ability to establish lifelong latency and reactivate during immunosuppression or stress.
💋 HHV-1 & HHV-2 (Herpes Simplex Viruses)
- HSV-1 → orolabial ulcers (“cold sores”), HSV-2 → genital ulcers.
- Other: herpetic whitlow (fingers), eczema herpeticum, neonatal HSV, encephalitis (temporal lobe).
- 🧪 Latent in sensory ganglia → reactivation with stress/immunosuppression.
- 💊 Treatment: Aciclovir PO (first/recurrent episodes), IV aciclovir for severe/encephalitis.
- ⚠️ Neonatal HSV = high mortality without urgent IV aciclovir.
🐔 HHV-3 (Varicella-Zoster Virus)
- Causes varicella (chickenpox) & herpes zoster (shingles, dermatomal vesicles).
- Complications: pneumonitis, encephalitis, hepatitis, retinal necrosis, post-herpetic neuralgia.
- 🧪 Latent in dorsal root ganglia → reactivation with age or immunosuppression.
- 💊 Oral aciclovir (start <72 h), IV aciclovir if severe/disseminated.
- ⚠️ Ophthalmic zoster threatens vision → urgent ophthalmology review.
🤒 HHV-4 (Epstein–Barr Virus, EBV)
- Infectious mononucleosis: fever, pharyngitis, lymphadenopathy, splenomegaly.
- Other: oral hairy leukoplakia, Burkitt’s lymphoma, Hodgkin’s lymphoma, nasopharyngeal carcinoma.
- 💊 Supportive treatment only. Avoid amoxicillin/ampicillin (rash).
- ⚠️ Splenic rupture → avoid contact sports for 3–4 weeks.
👁️ HHV-5 (Cytomegalovirus, CMV)
- Opportunistic infection in immunosuppressed (HIV, transplant).
- Clinical: retinitis (“pizza-pie fundus”), oesophagitis, colitis, pneumonitis, congenital CMV (sensorineural hearing loss).
- 💊 Ganciclovir/valganciclovir; foscarnet or cidofovir if resistant.
- ⚠️ Causes neutropenia → monitor FBC and renal function.
👶 HHV-6 & HHV-7 (Roseoloviruses)
- Cause roseola infantum: high fever → sudden defervescence rash.
- Can cause febrile seizures in infants.
- Reactivation in transplant patients → encephalitis, myelosuppression.
- 💊 Supportive. Severe disease may need ganciclovir/foscarnet (specialist).
🎗️ HHV-8 (Kaposi’s Sarcoma–associated Herpesvirus)
- Associated with Kaposi’s sarcoma, primary effusion lymphoma, multicentric Castleman’s disease.
- Seen especially in immunosuppressed (e.g., HIV/AIDS).
- 💊 ART optimisation, local therapies (surgery/radiotherapy), systemic chemotherapy (liposomal doxorubicin), rituximab for MCD.
- ⚠️ Can cause visceral involvement → GI bleeding, respiratory compromise.
