1. In the name of god

2. Herpes simplex Herpes simplex virus HSV1 HSV2
HSV1: cause a majority of cases of oral and pharyngeal infection, meningoencephalitis and dermatitis above the waist
HSV2: is implicated in most genital infections

3. Primary herpes simplex virus infections
Primary HSV infection occurs in patient who do not have immunity resulting from previous contact with the virus
The majority of oral HSV infections is caused by HSV1, but primary oral HSV infections may also occur chiefly result of oral-genital contact
Infection of the finger (herpetic whitlows) of health professionals may occur during treatment of infected patients.

4. During the first 6 months: are protected
Newborn After 6 month of age : incidence of primary
HSV1 infection increases
Between 2 and 3 years of age: incidence of
primary HSV1 infection reaches a peak

5. Incidence of primary HSV2 infection dose not increase until the age when sexual activity begins
The incidence of primary herpes infection has been shown to vary according to socioeconomic group

6. Clinical manifestations
History of generalized prodromal symptoms that precede the local lesions bye 1 or 2 days.
These generalized symptoms include fever, headache, malaise, nausea, and vomiting.
A negative past history of recurrent herpes labialis.
A positive history of direct intimate contact whit a patient whit primary or recurrent herpes

7. 1 or 2 days after generalized symptoms small vesicles (thin walled-inflammatory base) rupture shallow round discrete ulcers
An important diagnostic criterion in this disease is the appearance of generalized acute marginal gingivitis
Primary HSV in healthy children is self-limiting disease.

8. Laboratory diagnosis Cytology :giant cell. Syncytium. Ballooning
degeneration
HSV isolation: is the most positive method of
identification and sensitivity 100%
Antibody titers: antibody to HSV will begin to appear
in a week and reach a peak in 3 weeks

9. treatment Acyclovir : inhibits DNA replication in HSV
infected cell
Valacyclovir & famciclovir : effective treatment
with fewer doses.
Supportive treatment:1)aspirin or acetaminophen for
fever
2) fluids to maintain proper
hydration and electrolyte
balance.

10. Recurrent herpes simplex virus
Recurrent herpes is a reactivation of virus that remains latent in nerve tissue.
Several mechanisms for reactivation of latent HSV: low serum IgA, cell mediated immunity salivary antiherpes activity, ADCC and interleukin2

11. Clinical manifestations
Tingling or burning with edema a cluster of small vesicle(1-2 cm – 1 to 3 mm in diameter)

12. Diagnosis
Giant cell
Ballooning degeneration

13. Treatment Acyclovir: suppress the formation and
shorten the healing time of new
recurrent lesions.
Famciclovir: decrease the rate of HSV
latency

14. Good luck