By Dr Ananya Mandal, MD
The herpes simplex virus (HSV) leads to distinctive symptoms when it infects different parts of the body. The most common sites of infection include the skin and mucous membranes of the face. This is termed orofacial herpes. The second most common type of herpes infection affects the genitalia and is known of as genital herpes.
Some of the sites of herpes infection include:
Oral or orofacial herpes affecting the face and mouth
Herpes labialis or herpes sores over the lips
Genital herpes or herpes infection of the skin around the genitalia
Herpetic whitlow or herpes infection of the hands (specifically the thumb and fingers)
Herpes infection of the cornea in the eye or herpetic keratitis
Herpes infection of the brain or herpetic encephalitis.
Symptoms of herpes infection
Herpes infection is usually transmitted through skin-to-skin or sexual contact with an infected individual. The virus obtains access to the body through the membranous linings of the mouth, anus and genital tract as well as through contact with infected lesions or when skin abrasions are present. The virus can also be transmitted in the absence of any lesion or cut and when an individual has no symptoms.
Once inside the epithelial cells, the virus rapidly replicates before establishing latent infection in sensory nerve bodies. General symptoms of herpes infection include fever, malaise, headache, runny eyes, swollen glands and feeling unwell. The sores and other symptoms may last up to 20 days and heal without scar formation.
Herpes labialis manifests as sores and blisters over the lips and mouth.
Herpes genitalis manifests as clusters of painful and fluid-filled sores over the genitalia. The blisters may be present within the anus or vagina and there may also be vaginal discharge.
Herpetic whitlow refers to a condition where painful sores develop towards the ends of the fingers or thumbs. It may also occur on the toes or on the nail cuticles. Herpetic whitlow is more common among people who practice contact sports such as wrestling or rugby and is also called herpes gladiatorum or wrestler's herpes.
Herpetic keratitis leads to irritation of the eyes with small white lesions appearing. There may also be a gritty or itchy sensation in the eye, along with watering.
Herpetic encephalitis is most common in people with a diminished immune system. There may be an intense headache, convulsions, high fever, rigidity of the neck, unconsciousness, delirium, coma and even death.
In the case of neonatal herpes, the main sites affected are the skin, mouth and eyes.
Reviewed by Sally Robertson, BSc