A weird thumb infection in a child: Could it be herpes? (original) (raw)
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An Unusual Presentationof Herpes Simplex Virus Type 1Infection in a Child
Case Reports in Dermatology, 2013
We describe an 11-year-old girl presenting with lichen simplex chronicus (LSC) and acute bilateral carpal tunnel syndrome (CTS) following herpes simplex virus type 1 (HSV-1) infection as evidenced by serological data and by detection of HSV-1 DNA in the blood with the use of PCR. Based on the literature search, this case represents the first childhood case of LSC and acute bilateral CTS following HSV-1 infection. The experience with this patient emphasizes the importance of serological tests and PCR as well as the other laboratory techniques for the accurate diagnosis and management of the disease.
Acute hepatitis as a manifestation of primary HSV infection in a healthy child
Journal of Pediatric and Neonatal Individualized Medicine, 2019
Several herpesviruses can cause hepatic injury, but herpes simplex virus (HSV) is rarely involved in immune-competent patients, beyond the neonatal age. We report a rare case of acute hepatitis associated with primary HSV infection in a previously healthy child. Therefore, HSV infection should be actively investigated in healthy children developing acute hepatitis without acute liver failure, if the most common infectious agents have been excluded, despite the absence of the typical vesicular herpetic skin and/or mucosal manifestations.
The Natural History of Primary Herpes Simplex Type 1 Gingivostomatitis in Children
Pediatric Dermatology, 1999
Herpetic gingivostomatitis is the most common specific clinical manifestation of primary herpes simplex infection in childhood. The aim of the present study was to describe the clinical signs, symptoms, viral shedding, serologic findings, and complications in communityacquired gingivostomatitis. We prospectively followed children with herpes simplex type 1 gingivostomatitis lasting less than 72 hours. Clinical examination and viral culture were repeated every 2 to 3 days as long as symptoms or signs persisted. Thirty-six children (ages 12-77 months) were included in the study. Mean duration of oral lesions was 12.0 ± 3.4 days; extraoral lesions (in 26 children), 12.0 ± 3.9 days; fever, 4.4 ± 2.4 days; and eating/drinking difficulties, 9.1 ± 3.0 and 7.1 ± 3.1 days, respectively. In all children, viral cultures of the oral lesions were positive for herpes simplex virus (HSV) type 1; viral shedding persisted for a mean of 7.1 ± 2.5 days (range 2-12 days). The main complications were dehydration, with three children hospitalized for intravenous rehydration, and one case of secondary bacteremia. Herpetic gingivostomatitis is a relatively severe manifestation of primary HSV type 1 infection in young children.
Herpes Simplex Virus Type 2: An Update
The Nurse Practitioner, 2003
ost primary practitioners are unaware that many of their sexually active patients are infected with herpes simplex virus type 2 (HSV-2). Approximately 22% of the adult population in the United States is infected. 1 It is estimated that about 1.7 million new HSV-2 infections are acquired each year, and over half of new cases are asymptomatic or unrecognized. 2 Most cases of genital herpes result from HSV-2 infection, although the incidence of genital herpes caused by herpes simplex virus type 1 (HSV-1) is increasing. 3 HSV-1 is the virus that typically causes orolabial disease or "cold sores". Of significant concern is the role that HSV plays in human immunodeficiency virus (HIV) transmission. A recent review of the literature indicates that the risk of acquiring HIV is doubled for HSV-2 infected persons. In addition, genital ulcers facilitate HIV shedding in the genital tract of infected individuals, thereby increasing the likelihood of transmission to HIV-negative partners. 4 ■ Epidemiology Serum sample collection during the National Health and Nutrition Examination Surveys (NHANES) II and III, showed that among Caucasians in the general population, 15% of men and 20% of women are HSV-2 seropositive. Among African-Americans, 35% of men and 55% of women are seropositive. 1 Herpes is more common in women than men, infecting approximately one out of four women and one out of five men. It is common in both rural and urban areas in the United States. Rates of HSV-2 have risen quickly among adolescents and young adults in particular. Over the past two decades, HSV-2 seroprevalence has quintupled in white teenagers and doubled among young adults in their 20s. Between 1976 and 1994, the prevalence of HSV-2 was 5.4% among persons aged 12 to 19 years and 17.2% among persons aged 20 to 29 years. 1 Seroprevalence of HSV-2 is virtually nonexistent in persons younger than 12 years of age, peaks by the age of 40, and remains stable thereafter. HSV-1 infection is usually transmitted during childhood and adolescence and, if symptomatic, is commonly characterized by oral or facial lesions. 5 ■ Presentation and Natural History The physical manifestations of a genital herpes infection range from truly asymptomatic to severe disease. Immunosuppressed individuals or intrapartuminfected neonates are particularly vulnerable to severe consequences of a HSV infection. The most important aspect of clinical presentation for the NP to be aware of is that the "textbook" presentation of genital herpes is rarely seen. Herpes can masquerade as many other disorders, including: gonorrhea, non-gonococcal urethritis, syphilis, erosive lichen sclerosis,
Herpes Simplex Virus 1 infection: misleading findings in an infant with disseminated disease
The new microbiologica, 2013
Neonatal Herpes Simplex Virus (HSV) infection is a serious illness with significant mortality and morbidity for disseminated disease. Clinical diagnosis of neonatal HSV infection is often difficult without evidence of HSV exposure, for example, absence of a rash or the presence of non-specified manifestations in an infant. Early recognition and treatment with high-dose Acyclovir may dramatically improve the short and long-term outcomes. We describe an infant with disseminated disease due to HSV-1 infection, who first presented clinical and radiologic features of pneumonia. The diagnosis was performed post-mortem by Real-Time Polymerase Chain Reaction (PCR) analysis of blood, cerebrospinal fluid and pleural liquid of the infant. Tissue PCR revealed a disseminated HSV-1 infection, with a high viral load detected in liver, lungs, brain, heart, striated muscle, kidneys, and thymus tissues. This case report highlights the need for neonatologists to raise awareness about the different cli...
Neonatal Herpes Infection: Case Report and Discussion
The Journal of the American Board of Family Medicine, 2011
Neonatal herpes simplex virus (HSV) infections are often life-threatening. Although sometimes difficult to diagnose, most infections can be treatable when found early. Infection with HSV should be kept high on the differential diagnosis of a febrile newborn younger than 1 month old, and treatment should be strongly considered for infants with certain risk factors, even before definitive culture or polymerase chain reaction results are available. The case presented here exemplifies the benefits of maintaining a high suspicion of and empirically treating for HSV in a 10-day-old febrile infant.(J Am Board Fam Med 2011;24:758 -762.)
Clinical presentation heterogeneity of HSV1 oral lesions in immunosuppressed patients
Journal of Oral Diagnosis, 2020
Herpes simplex virus type 1 (HSV-1) may be considered the main etiological viral agent in oral infections. As its symptoms bear similarity with other oral lesions within immunosuppressed patients, the diagnosis of herpes may be mistaken for other diseases. Therefore, the investigation of a technique that better detects this virus is important to assure a treatment that is more effective and adequate for this case. The study aimed to describe four cases of immunosuppressed patients presenting HSV-1 lesions, whose diagnosis was confirmed using polymerase chain reaction (PCR). Four hematopoietic stem cell transplant patients referred to the dental clinic complaining about oral lesions, pain, and functional difficulties. Multiple ulcers were observed in different sites of the mouth. Exfoliative cytology was performed and the diagnosis was confirmed by qualitative real-time PCR, in which HSV-1 was detected in the four cases. Specific techniques for the diagnosis of viral infections should be instituted for immunosuppressed patients presenting oral ulcers, since opportunistic infections can spread rapidly in these individuals, leading to increased morbidity and mortality.
European Journal of Pediatrics, 2004
We report a case of neonatal herpes presenting with liver failure and disseminated coagulopathy which followed unrecognised maternal primary genital herpes and was diagnosed by herpes simplex virus DNA detection in blood by polymerase chain reaction 2 weeks after initiation of empiric intravenous aciclovir. The child underwent liver transplantation while receiving suppressive antiviral therapy and remains well after 10 months of follow-up. Conclusion: Our case highlights potential pitfalls in the diagnosis of neonatal herpes and indicates a role for blood herpes simplex virus polymerase chain reaction as a sensitive diagnostic tool in disseminated infection. It is one of very few reports where liver transplantation has been successfully carried out in a neonate with herpes simplex virus-induced liver failure.