Cold Sores Treatment Diet
Herpes simplex virus can persist in a latent form in the trigeminal ganglion and when re-activated causes recurrent infections. These are typically seen at the mucocutaneous junctions of the mouth or nasal cavity, and involvement of the lips, the most common site, is called herpes labialis. A variety of apparently disparate factors can trigger re-activation, including the common cold ( fever blister ), exposure to sunlight, menstruation, stress and others. There is usually a brief prodromal burning or prickling sensation in the
Herpes labialis or a dermatomal vesicular eruption (suggestive of shingles) is indicative of a herpetic conjunctivitis. B. Purulent discharge suggests a bacterial infection. Stringy mucoid discharge suggests allergy. Clear watery discharge suggests viral infection.
Most DNA viruses of animals contain double stranded DNA. For example, Simian Virus 40 (SV40) is a smallish, spherical virus that causes cancer in monkeys by inserting its DNA into the host chromosome. Another double stranded DNA virus, Herpes virus, is spherical with an extra outer envelope of material stolen from the nuclear membrane of the host cell (Fig. 17.14). The internal nucleic acid with its protein shell is referred to as the nucleocapsid. This family includes viruses that cause cold sores and genital herpes as well as chickenpox and infectious mononucleosis. The herpes viruses are difficult to cure completely as they are capable of remaining in a latent state where they cause no damage but merely replicate in step with the host cell. Active infections may then break out again after a long period of quiescence, due to stress or other factors.
The following drugs are used primarily in the treatment of herpesviruses. Among these are herpes simplex virus-1 (HSV-1), which typically causes herpes labialis (cold sores) or herpes esophagitis herpes simplex virus-2 (HSV-2), which is responsible for most cases of genital herpes varicella zoster virus (VZV), which produces chickenpox and shingles Epstein-Barr virus (EBV), which is the major cause of infectious mononucleosis and cytomegalovirus (CMV), which can produce pneumonia, gastroenteritis, retinitis, encephalitis, and mononucleosis in immunocompromised individuals.
Figure 24.9 Herpes Simplex Labialis, Also Known As Cold Sores or Fever Blisters The photomicrograph is of stained material from a herpes simplex lesion. It shows a multinucleated giant cell and intranuclear inclusion bodies.The pink areas within the epithelial cell nuclei are inclusion bodies, the sites of viral replication. Figure 24.9 Herpes Simplex Labialis, Also Known As Cold Sores or Fever Blisters The photomicrograph is of stained material from a herpes simplex lesion. It shows a multinucleated giant cell and intranuclear inclusion bodies.The pink areas within the epithelial cell nuclei are inclusion bodies, the sites of viral replication.
Clinicians had noted for some time the relationship between physical stress and the appearance of fever blisters (cold sores) or genital herpetic lesions. This suggested a role for epinephrine in the process, and various investigators showed that topical or intravenous applications of epinephrine could cause reactivation of HSV-1 in rabbits. Researchers from Hill's group (118,119) were the first to report that transcorneal iontophoresis of this agent could induce viral shedding in rabbits harboring latent HSV-1. They inoculated rabbits with HSV-1 and 60 days later performed epinephrine iontophoresis on one eye from each rabbit. A 0.01 epinephrine solution was iontophoresed (0.8 mA for 8 min) once daily for 3 consecutive days. Viral shedding was verified by ocular swabbing and culturing the tear film in cell culture. Antigenic and or nucleic acid analysis was used to confirm the identity of the viral isolate. Epinephrine iontophoresis resulted in HSV-1 viral shedding in all treated...
Although HSV-1 is generally considered to be associated with orofacial infections and HSV-2 with genital infections, both serotypes can affect any region of the body. Both HSV-1 and HSV-2 cause a wide variety of clinical syndromes in humans (e.g., herpes labialis, gingivostomatitis, keratocon-junctivitis, herpes genitalis) with the basic lesion being an intraepithelial vesicle from which progeny virus is shed. It is during the primary infection that virus particles first enter sensory nerve endings that innervate the lesion and are then transported to the local sensory ganglia (e.g., trigemi-nal ganglia for orofacial infections dorsal root ganglia for genital infections). Once the virus reaches these sensory ganglia, the virus may either produce an acute infection resulting in subsequent neuronal cell death or enter a dormant or latent phase (reviewed in Jones, 2003). During this latent state, there is restricted viral gene expression that is limited to the production of what are...
The causative agent of genital herpes is usually herpes simplex virus type 2 (HSV-2), a medium-sized, enveloped, double-stranded DNA virus. On electron micrographs it looks like herpes simplex virus type 1 (HSV-1), the cause of cold sores ( fever blisters, herpes simplex labialis), and the genomes of the two viruses are about 50 homologous. This disease, like cold sores, often recurs, because the virus becomes latent. Either virus can infect the mouth and the genitalia, but the type 2 virus causes more severe genital lesions whose frequency of recurrence is greater than that of the type 1 virus. During initial infection and for as long as 1 month after, the virus is found in genital secretions. During recurrence, the virus is usually present in large numbers for less than a week. HSV-1, p. 607
There are very few effective antiviral drugs because it is difficult to formulate a drug that eradicates the virus from the cells without also killing the cells themselves. The currently available antiviral therapeutics are mostly effective in treating the herpes virus, of which there are 4 main types. The first is the herpes simplex virus (the cause of cold sores), genital herpes, and herpes simplex keratitis. The second is the varicella zoster virus, the virus causing chicken pox and shingles. The third variety is the Epstein-Barr virus, which causes mononucleosis. Last, is the cytomegalovirus, a common infectious agent in AIDS patients.
This can give rise to a particularly severe form of amnesic syndrome.(25) The majority of cases are said to be primary infections, although there may be a history of a preceding 'cold sore' on the lip. Characteristically, there is a fairly abrupt onset of acute fever, headache, and nausea. There may be behavioural changes. Seizures can occur. The fully developed clinical picture with neck rigidity, vomiting, and motor and sensory deficits seldom occurs during the first week. (26) Diagnosis is by finding a raised titre of antibodies to the virus in the cerebrospinal fluid, but often this is missed and a presumptive diagnosis is made on the basis of the clinical picture as well as severe signal alteration, haemorrhaging, and atrophy in the temporal lobes on MRI brain imaging.
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