Herpes, Type I

500,000 new cases of HSV-1 each year in USA (prevalence approximately 68%); 58% of people worldwide are seropositive.

Symptoms are typically minor (malaise, myalgias, and painful vesicular oral lesions) or absent, except in immunocompromised pts.

Theoretical risk that spinal anesthesia can spread HSV-1 infection to new dermatomes.

Association of intrathecal morphine and reactivation of HSV-1 infections in obstetric population.

Transmission of infection to healthcare workers or other pts

Reactivation after organ transplantation and initiation of immunosuppression

Secondary infection of herpetic lesions with bacteria or fungi

Transmission occurs after contact with secretions or mucus.

Primary infection associated with fever/malaise, with a mean duration of 19 d. Recurrences are milder, with a mean duration of 10 d.

Lesions recur about once per y (in contrast with four times per y for HSV-2) in immunocompetent pts.

27% of the population is seropositive by age 4.

Oral symptoms include gingivostomatitis/oral ulcers. Genital, ocular, pneumonitis, and additional dermatologic infections may occur.

Symptoms may last 1–4 wk.

Can be diagnosed via a viral culture (titer 1000 times nml while active lesions exist) or HSV antibodies.