Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

Herpes Type 1/Type 2 Herpes Zoster 707

Eye infections (usually HSV-1)

■Uni- or bilateral conjunctivitis

■Blepharitis

■Pain

■Photophobia

■Blurred vision

■Tearing

■Preauricular adenopathy

Neonatal

■Potential fatal, very serious with high risk of neurologic disease

■3 main categories:

➣Skin, eye and mouth

➣CNS

➣disseminated

Special Hosts

■Immunosuppressed pts (malignancy, organ transplant, HIV) often

develop severe complications from herpes infection – e.g.:

➣Esophagitis

➣Hepatitis

➣Anogenital ulceration

➣Interstitial pneumonia

➣Focal necrotizing pneumonia

Herpes Zoster.......................................

JEFFREY P. CALLEN, MD

history & physical

History

■Recurrence of chickenpox (varicella zoster virus)

■Usually there is a prodrome of several days.

■Physical findings are often preceded by severe dermatomal pain.

Signs & Symptoms

■Initial lesions are erythematous papules followed shortly by vesicles.

■Dermatomal distribution

tests

■Tzanck smear

■Culture is possible, but varicella zoster virus is more difficult to cul-

ture than herpes simplex.

■Biopsy is rarely needed.