Herpes In Children Of Type 6 On The Lips, Throat And Body, Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Herpes in children

Content:

• Herpes virus in a child
• Symptoms of herpes in a child
• The causes of herpes in children
• Herpes type 6 in a child
• Herpes in children on the lips
• Herpes on the face in children
• Herpes zoster in children
• Genital herpes in children
• Herpes in the throat of a child
• Treatment of herpes in a child

Herpetic infections - the most common human viral diseases, belong to the group of opportunistic infections. They inflict maximum damage on people with imperfect homeostasis. First of all, herpes viruses are dangerous to children, especially those with a low immune status.

Herpes virus in a child

Herpes viruses are intracellular parasites localized inside the cells of the body's nervous system. To date, there are eight types of herpes pathogens that cause human diseases, these are viruses:

• herpes simplex (nasolabial herpes), or the first type - HSV-1;
• herpes simplex (genital herpes), or the second type - HSV-2;
• chickenpox and herpes zoster, or the third type - HSV-3;
• Epstein-Barr, or the fourth type - HHV-4;
• cytomegalovirus, or the fifth type - HHV-5;
• the sixth type, or the sixth type - HHV-6;
• the seventh type, or the seventh type - HHV-7;
• the eighth type, or the eighth type - HHV-8.

Herpesviruses are the most common group of opportunistic infections. The name “opportunistic infection” means a disease that causes maximum harm during the period of a helpless state of the body (childhood, old age, people with HIV, concomitant pathologies).

Localization of herpes viruses in nerve cells means their inaccessibility for many drugs and a kind of pathogenesis.

1. Inaccessibility of herpesviruses. Provides a biological barrier around the nerves. Antibiotics of all known pharmaceutical groups, especially during the period of latent infection, do not overcome the blood-brain barrier, this greatly complicates treatment;

2. Pathogenesis of herpes viruses associated with the localization of the virus:

   • in mild cases, it is a rash on the skin, mucous membranes along the nerves.
   • in severe cases, it is nerve damage (cerebral, local nerve damage).

The causative agents of opportunistic infections are taxonomically heterogeneous, these are viruses, bacteria, protozoa. Opportunists have common features that unite different nosological groups of diseases, including herpes viruses.

1. High contagiousness of pathogens. Herpes overcomes the body's defenses in all forms of infection.

2. The latent (latent) course of infection is provided by immunosuppression (suppression) of the virus, in particular:

   • in case of primary contact with herpes - the cooperation of all links of the immunocompetent organism (immunity is imperfect in children, sick adults);
   • after contact with herpes - the specific protective immunity of a healthy person (protective immunity is not developed enough in children, sick adults).
3. Damage to the body's immune defenses makes it difficult to contain the virus. The infection progresses to the stage of clinical manifestation. The pathogenesis of infection is directly proportional to the level of damage to the immune system. The immunity is most vulnerable in children with chronic diseases.
4. Against the background of the pathogenesis of opportunistic infection, secondary immunity deficiency develops.

Herpesviruses, like all opportunistic infections, are a marker of the body's immunodeficiency state, including in HIV infections.

Symptoms of herpes in a child

Herpetic infections are characterized by clinical polymorphism. Common, for almost all herpes, the symptoms are defined as asthenic-vegetative syndrome.

Against the background of a variety of symptoms, general clinical symptoms of herpes in children are often identified:

• hyperthermia at the level of febrile indicators (38-39 ⁰ C);
• headache;
• fatigue, lethargy, irritability;
• pains localized in the skin, joints, muscles.

The most common specific symptoms are:

• polymorphic skin rashes, the main type of rash is vesicles (vesicles);
• damage to the lymph nodes, in the form of single or batch lesions;
• damage to the mucous membranes;
• organs of vision;
• signs of damage to the nervous system (encephalitis, myelitis, encephalomyelitis).

More accurate information about the causative agent of herpesvirus infection is obtained by laboratory methods. Confirmation is carried out using a combination of polymerase chain reaction (PCR) methods - detects the genome of the virus (including in the inactive phase), enzyme-linked immunosorbent assay (ELISA) - detects specific immunoglobulins IgM (early stage) IgG (reactivation).

1. Laboratory markers of primary infection:

   • the presence of DNA of the virus of detectable herpes;
   • detection of specific Ig M antibodies to the detected virus;
   • absence of specific IgG antibodies to the detected virus.

2. Reinfection laboratory markers:

   • the presence of DNA of the virus of detectable herpes;
   • detection of specific Ig M antibodies to the detected virus;
   • early detection of specific IgG antibodies to the detected virus..

The causes of herpes in children

Herpes causes a variety of triggers in children. Distinguish:

• congenital, when the child's body, due to genetically determined reasons, does not have protective antiherpetic mechanisms;
• acquired as a result of a decrease in homeostasis after an illness, forced drug therapy aimed at suppressing immunity, and other reasons.

Herpes type 6 in a child

Herpes simplex virus type six (HHV-6) was first isolated in 1986. The first contact with the virus is registered at the age of 6 months to two years. By the age of three years of age, specific antibodies to HHV-6 are detected in 100% of the examined, clinically healthy children.

Signs of herpes type 6 in children

The main signs of the clinical manifestation of HHV-6 in children:

• high temperature (fever) above 39 ⁰ С for more than two days;
• there are no signs of a cold and / or intestinal infection;
• sudden rashes on the body - baby roseola (one of the main symptoms) on the face, chest, abdomen, all over the body.

The following signs of the sixth herpes are possible:

1. convulsions against a background of high fever;
2. acute tonsillitis - inflammation of the tonsils;
3. inflammation of the oral cavity, the mucous membrane is covered with vesicles (aphthae);
4. neurological signs.

During the initial clinical examination of a patient, the doctor has to take into account many factors that confirm the wide polymorphism of the clinical manifestations of opportunistic infections.

Symptoms of herpes type 6 in children

Symptoms that are clinical markers of HHV-6 and associated infections.

1. Convulsions in a child at febrile temperature.

   When diagnosing HHV-6, it should be borne in mind that the cause of seizures, approximately 80%, is a combination of several infections.

   Febrile seizures, with HHV-6, can be signs of other childhood infections, for example, a combination of:

   • adenovirus infection, its combination with parainfluenza, influenza;
   • parainfluenza + HVS1.2;
   • HHV-6 + bacterial infections.

2. Tonsillitis

   When diagnosing HHV-6, it should be borne in mind that tonsillitis, approximately 90% of a combination of several infections.

   Acute inflammation of the tonsils (tonsillitis):

   • a combination of HHV-6 + adenovirus + bacterial infection;
   • herpes Epstein-Barr.

3. Stomatitis

   When diagnosing HHV-6, it should be borne in mind that stomatitis, approximately 50%, is a symptom of several infections accompanying the sixth herpes.

   Stomatitis (inflammation of the mouth):

   • combination of adenovirus + HVS1,2;
   • HVS 1.2.

4. Neurological symptoms

   When diagnosing, HHV-6 can also indicate other pathologies affecting the brain, back, brain.

   Neurological symptoms of the sixth herpes:

   • signs of meningoencephalitis;
   • cerebellar ataxia - "dancing" eye syndrome;
   • hemiparesis.

Herpes in children on the lips

Herpes simplex (HVS-1) or herpes on the lips is characterized by blistering eruptions on the nasolabial area of the face. For a long time, the pathogenesis of the disease caused by herpes-1 was considered commonplace. After the introduction of modern methods into research practice, the significant effect of herpes on human health, especially children, has been proven.

In case of violations of the cellular cooperation of immunity, a connection has been established between HVS-1 and pathologies:

• upper respiratory tract;
• gastrointestinal tract;
• nervous system;
• organs of vision;
• reproductive system.

By the age of 15, 80-100% of children are infected with the virus. The main routes of transmission of infection are airborne, contact.

The most common form of infection is persistent (latent). The activation of the virus occurs against the background of a decrease in the immune status, allergies, concomitant infections. Reactivation is possible at any age.

Signs of herpes simplex on the lips in children

Signs of an uncomplicated manifest form of herpes simplex on the lips in children

• vesicular rash on the lips and nasolabial triangle;
• rashes on the mucous membranes of the oral cavity;
• temperature rise to febrile values of 38-39 ⁰ С.

The addition of signs of rashes on other parts of the body, symptoms of toxicosis - depression, lethargy, signs of encephalomyelitis are evidence of a combined infection, the development of severe pathogenesis.

The lethal outcome in severe forms of pathogenesis reaches 50-80%. After timely medical assistance, the virus turns into an inactive, persistent form of infection.

An unfavorable course of HVS-1 in children is considered to be a relapse of the disease from 2 to 4 times a year, an acceptable level of infection is a single exacerbation per year, a favorable course of infection if herpes is recorded less than once every two years.

Herpes on the face in children

Rashes on the child's face are accompanied by diseases such as:

• herpes simplex (HVS1,2);
• herpes zoster (HHV-3);
• chickenpox (HHV-3);
• other viral, bacterial infections - scarlet fever, impetigo, congenital syphilis;
• allergic pathologies.

The most common childhood pathology is chickenpox. Infection of children with the HHV-3 virus is very high, reaching 1 thousand per 100 thousand. The main method of transmission of infection is airborne. A perinatal route of infection is possible. The incubation period is 10-21 days. After an acute period of illness, the herpes-3 virus goes into an inactive state.

Persistence in the nerve nodes is lifelong. The reactivation of the herpes-3 virus causes a disease called herpes zoster.

In infants, the primary disease is mild. Children of school age, adults with initial contact with the virus, children of all ages with low immune status are seriously ill.

Signs of chickenpox in children of different ages

• Vesicular rash on the face, then throughout the body.
• Itching is characteristic of pathogenesis, children over three years old - 70%, infants - 15% of cases.
• The disease in infants is manifested by a mild catarrhal syndrome (hyperthermia 37-38 ⁰ C for 2-3 days, redness of the mucous membrane of the throat, cough, runny nose).
• The disease in children over three years of age is manifested by pronounced infectious toxicosis (hyperthermia 38-39 ⁰ C for 4-5 days, weakness, lethargy, headache, runny nose. hallucinations, other signs of damage to the nervous system).

The debut of a rash with chickenpox. - Small scarlet-like specks of the first day of illness against the background of an increase in temperature. Characterized by polymorphism of the rash, that is, there are simultaneously different stages of the rash from the primary - papule, vesicle; to secondary - crusts. This is due to the constant process of formation, maturation, disappearance of the rash.

Characteristics of facial vesicles in children

Vesicle - a rash with transparent contents, the main type of rash with herpes infections. Other possible types of facial rashes are not considered in this case.

• Herpes simplex (HSV-1) - localization of vesicles in the area of the nasolabial triangle of the face.
• Herpes zoster (HHV-3) - vesicles tend to join into a single focus, characterized by severe soreness of the rash.
• Chickenpox (HHV-3) - solitary foci, vesicles are scattered over the face, body.
• Allergic rash - areas of redness around the rash, severe itching.

A rash with bacterial infections is, first of all, pustular rashes - pustules. Pustules with viral and allergic ones appear as a secondary pathological process after seeding of skin scratches with pyogenic bacteria.

Herpes zoster in children

There are isolated reports of the reactivation of Varicella zoster virus and the re-illness of children, the younger age group, with herpes zoster, the causative agent of HHV-3.

The causes of herpes zoster in children in the first years of life are chickenpox disease:

• a child in the first year of life;
• mothers during pregnancy.

The main differences between herpes zoster in children

The course of uncomplicated herpes zoster in children is characterized by:

• mild pathogenesis;
• the absence of acute pain in the area of the rash;
• the absence of residual pain after the disappearance of the rash.

In adults, the zoster virus causes more severe manifestations, accompanied by severe pain, often persisting for a long time, after discharge from the hospital.

Severe pathogenesis of herpes zoster can be in children with low immune status.

Signs of herpes zoster - a reason to consult a doctor

There are such signs of herpes zoster in children:

Vesicular eruptions are characteristic:

• bubbles with a clear liquid on the cheeks, trunk;
• usually on one side of the face, body;
• the rash tends to pool;

Vesicular rashes in children can form against a background of normal temperature. The appearance of herpes zoster in children is associated with the immunosuppressive effects of other types of herpes viruses (Epstein-Barr, cytomegalovirus).

Herpes zoster in children with immunodeficiency

It is characterized by a persistent course of pathogenesis, with pain syndrome during the formation of rashes, after the end of pathogenesis. In about 5-15% of children, motor nerves are involved in the pathological process with consequences in the form of paresis and paralysis that pass after a while. Pathogenesis, accompanied by necrosis of areas of the skin in places of the rash. Persistent relapses of herpes zoster are a reason for suspecting a child's immunodeficiency.

Herpes zoster during pregnancy

The disease is complicated by pneumonia, encephalitis. The presence of an established infection is the basis for hospitalization in order to preserve the bearing of the fetus.

Genital herpes in children

HVS-2 is the second serotype of the herpes simplex virus, affecting primarily the mucous membranes of the external genital organs.

The herpes virus-2 belongs to the group of sexually transmitted diseases. Possible infection with the HVS-2 virus, before puberty, at the stages of embryogenesis, human ontogenesis. The following routes of transmission of herpes-2 from mother to fetus are proven:

• transcervical - infection through the amniotic fluid;
• transplacental - penetration of the umbilical vein through the bloodstream;
• transovarial - infection through the fallopian tubes;
• contact - infection during childbirth.

The greatest susceptibility to herpes-2 in children aged 5 months to 3 years, adults -16-25 years. Initial contact with the virus in 80-90% is not accompanied by clinical manifestations. Infection of children before puberty with HVS-2 occurs through everyday contact - linen, a shared towel.

Signs of genital herpes in children - a reason to see a doctor

There are such signs of genital herpes in children:

• vesicular rashes of the mucous membranes of the external genital organs;
• itching, pain in the area of the rash;
• hyperthermia 37-38 ⁰ C.

Rash of genital herpes can manifest itself on the nasolabial triangle, other parts of the body. Genital herpes is prone to recurrence. More than 50% of initially infected children get sick again. The frequency of virus reactivation depends on the state of the immune system.

Clinical stage genital herpes can occur in:

• mild abortive form - up to 90% of all cases of exacerbation of genital herpes;
• severe form - up to 10%.

The severe form of genital herpes is accompanied by deep erosions on the mucous membranes of the external genital organs. In severe pathogenesis, the brain of its shell is affected. Similar lesions can also occur with HSV-1 and other types of herpes.

Genital herpes, in clinical form, of a pregnant woman ends in abortion:

• early terms - 55% of cases;
• late terms - 25% of cases.

Clinical forms of genital herpes in newborns

Infection of the fetus on the eve of childbirth is accompanied by a disease in the first hours after childbirth. Infection of the fetus during childbirth is accompanied by illness of the newborn within two weeks of birth.

There are three forms of genital herpes in newborns:

• Localized. (20-40% of HVS-2 diseases in newborns). Damage to the skin, mucous membranes of the mouth, eyes. Rash in the form of single bubbles, hyperemia, edema, on the 5-14th day of the child's life. If infected late in pregnancy, the newborn may be born with a rash. The most dangerous is localization in the eye area, damage up to corneal ulcers and optic nerve atrophy.
• Generalized. (20-50% of HVS-2 newborns). Pathogenesis develops 5-10 days after birth. It manifests itself as septic phenomena (lethargy, regurgitation, respiratory failure, cyanosis, vesicles on the skin, rashes on the mucous membranes, yellowness of the mucous membranes, convulsions, coma). Lethality is 80-90%.
• Brain damage. (up to 30% of HVS-2 diseases in newborns). Occurs 2-3 weeks after birth. Rapid increase in symptoms (fever, lethargy, alternating with agitation, vomiting, tremors, convulsions, coma). Mortality 50% within 6-7 days.

Herpes in the throat of a child

Herpes in the throat, sometimes, so designate infectious mononucleosis, which is characterized by fever, lesions of the mucous membranes of the pharynx, lymph nodes. The disease is multifactorial. The causative agent of infection can be one of the herpes viruses, as well as other viruses, bacteria, protozoa in the form of mono- and mixed infections.

The main causative agents of infectious mononucleosis:

• herpes type IV - Epstein-Barr virus (EBV) - was previously considered the only causative agent;
• herpes V type - cytomegalovirus (CMV) - a common pathogen;
• herpes type VI - (HHV-6);
• herpes type I and II - herpes simplex virus (HVS-1,2);
• various combinations of herpes viruses of types I, II, IV, V, VI;
• adenoviruses;
• bacteria;
• protozoa.

The variety of pathogens determines the variety of symptoms of infectious mononucleosis. Clarify the diagnosis using laboratory tests - ELISA, PCR. The most promising is the immunohistocytochemical method (ICH).

Typical signs of herpes in the throat of a child - a reason to see a doctor

The following typical symptoms of herpes in the throat of a child are distinguished:

• body temperature from 38 to 39 ⁰ С;
• inflammation of the pharyngeal tonsil - difficulty in nasal breathing;
• angina - inflammation of the tonsils, pain when swallowing;
• enlarged regional lymph nodes;
• rashes on the body.

Infectious mononucleosis does not have a pathognomonic symptom, the primary signs resemble (acute respiratory infections, tonsillitis, adenoiditis).

Diagnostic errors during the initial examination are 30-60%.

Infectious mononucleosis is more often recorded in the cold season, about 70% of cases. Among children of the first years of life, boys are more likely to fall ill. The approximate ratio of sick infants, boys - 72%, girls - 28%. In adolescence, 10-15 years, the ratio changes, which is probably due to hormonal characteristics of different sexes. The approximate ratio of the incidence of infectious mononucleosis in adolescents, girls - 66%, boys - 34%.

In the first year of life, the incidence is low, due to the presence of maternal antibodies in the blood of infants. At the age of 2-3 years, the incidence rises sharply. It stabilizes in the population of preschool and primary school age at the level of 1.2 cases per 100 thousand children. The next twofold increase in the incidence is recorded in adolescence (10-15 years and older). It is caused by the formation of sexual activity at a young age. Infectious mononucleosis is sometimes called kissing and student disease.

Causes of infectious mononucleosis

The disease can develop as a primary contact or occur under the influence of internal and / or external factors such as reactivation of the virus. It was noticed that some time before the disease, about 1/3 of the children were examined by a pediatrician for tonsillitis, otitis media, adenoiditis, herpetic stomatitis. In half of families with a child with infectious mononucleosis, there are frequent (more than 4 times a year) herpetic diseases.

The most common cause of infectious mononucleosis for all age groups of children is:

• mixed infection - about 60%
• monoinfection - about 40%.

Among the causes of monoinfection, the following herpes viruses predominate:

• Type IV (EBV) - more than half of the cases;
• Type V (CMV) is a frequently reported cause;
• I and II types (HVS1,2);
• Type VI (VHCh-6).

In the structure of mixed infections in adolescents, the combination is reliably more often detected:

• EBV + HVS-1,2 - about half of cases;
• EBV + CMV is a common combination.

Pathogenesis of infectious mononucleosis

The most likely trigger is another infection. A severe pathogenesis of herpes combinations in infectious mononucleosis was established.

1. EBV + HVS-1,2. It is characterized by a sudden onset, moderate fever, severe intoxication (drowsiness, lethargy), swollen lymph nodes, rapid development of lacunar or ulcerative-necrotic sore throat, sore throat. Such symptoms are not common with mono EBV and HVS-1,2 infections. It was noticed that fever of mixed forms of infection in comparison with mono-infections with EBV, HVS-1,2 persisted:

   • 9-10 days with mixed infection;
   • 5-7 days for mono-infection with EBV or HVS-1,2

2. VEB + CMV. It is characterized by pathogenesis in the form of:

   • swelling of the nasopharyngeal mucosa;
   • intense hyperemia;
   • hypertrophy of the tonsils II-III degree
   • duration of fever - about 13 days - mixed infection, about 5 days - mono infection.

Treatment of herpes in a child

There is no single tactics or treatment regimen for the treatment of various types of herpes infections. Therapeutic techniques are determined individually in each case.

Treatment for sick children includes:

• etiotropic treatment during the period of primary contact and reactivation of the virus (with specific antiviral drugs of different groups, immunotherapy).
• immunorehabilitation during the latent course of infection, with frequent relapses, with the help of fractional courses of immunomodulators that can compensate for the damaged link of the body's defense
• preventive therapy of relapses (medication, physiotherapy, adaptogens, restoration of the biocenosis of bifidobacteria)

Below are the pharmaceuticals registered in the country used for the treatment and prevention of all forms of herpes infections. In therapy, antiviral drugs, specific and nonspecific immunomodulators are used that affect individual links of the immune system.

On the subject: folk remedies for herpes

Antiviral drugs

Abnormal nucleotides:

• Acyclovir;
• Valtrex (Valociclovir);
• Vectavir (Penciclovir);
• Famvir (famciclovir);
• Cymeven (Ganciclovir);
• Gevizosh (Epervudin);
• Oftan IDU (Idoxyuridine).

Specific inhibitors:

• Alpizarin (Mangiferin).
• Hyporamine;
• Bonafton ointment;
• Oxolinic ointment;
• Riodoxol ointment.

Preparations based on glycyrrhizic acid:

• Gerpigen bottle;
• Viusid;
• Herpinate lip cream.

Means of immuno- and interferon replacement therapy

Immunoglobulin preparations:

• Human immunoglobulin is normal donor;
• Cytotex.

Interferon preparations:

• Reaferon EU;
• Infagel ointment;
• Leukocyte interferon;
• Viferon suppositories rectal suppositories;
• Rebif.

Immunomodulators

Interferon inducers:

• Amiksin;
• Neovir;
• Cycloferon;
• Ridostin for injection;
• Poludan;
• Arbidol.

Immunomodulators, mainly acting on macrophages:

• Polyoxidonium;
• Tamerite.

Immunomodulators, mainly acting on T-lymphocytes:

• Immunofan;
• Roncoleukin;
• Affinoleukin;
• Isoprinosine;

Mixed-action immunomodulators:

• Glutoxim;
• Ferrovir;
• Imudon;

Cultural vaccine (inactivated herpes simplex virus type I and II)

The author of the article: Sokolova Praskovya Fedorovna | Pediatrician

Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.