Herpes Encephalitis And Meningitis
Herpes simplex encephalitis is inflammation of the brain caused by either HSV-1 or HSV-2. It is a rare but extremely serious brain disease. Untreated, herpes encephalitis is fatal most of the time. Respiratory arrest can occur within the first 24 to 72 hours. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis.
Herpes simplex meningitis is inflammation of the membranes that line the brain and spinal cord. It is mainly caused by HSV-2. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light. Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur.
When To Call The Doctor
Even though HSV sores can hurt and be unsightly, most cases of herpes do not cause serious illness. The sores go away in a few days. Contact the health provider if:
- Sores are present and you think it might be a first herpes infection. The diagnosis is usually made by examining the sores. If the sores have not healed, sometimes a laboratory test is done.
- Sores do not heal by themselves or show signs of infection such as pus, spreading redness or fever.
- Sores are near the eyes.
- You have another health condition with a weakened immune system.
How Long Can Herpes Go Undetected
Once youve contracted HSV, there will be an incubation period the time it takes from contracting the virus until the first symptom appears.
The incubation period for HSV-1 and HSV-2 is the same: 2 to 12 days. For most people, the symptoms begin to show up in about 3 to 6 days.
However, according to the
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Can I Treat Herpes Simplex At Home
Avoiding known triggers, such as illness or stress, can help reduce how often you have herpes outbreaks.
How can I ease my symptoms during an outbreak of HSV-1 ?
- Over-the-counter creams such as L-lysine, benzocaine or docosanol .
- Applying ice to blisters or sores.
How can I ease my symptoms during an outbreak of HSV-2 ?
- Apply an ice pack to your genitals. Wrap the ice pack in a washcloth or apply it over your underwear.
- Keep your genitals dry. Wear cotton or other nonsynthetic underpants and avoid tight-fitting clothes. Moist sores take longer to heal.
- Soak in a warm bath.
- Take nonsteroidal anti-inflammatory drugs to relieve pain.
- Topical 1% or 2% lidocaine may be used as a topical analgesic.
How Should I Take Valacyclovir Tablets
- Take valacyclovir tablets exactly as prescribed by your healthcare provider. Your dose of valacyclovir tablets and length of treatment will depend on the type of herpes infection that you have and any other medical problems that you have.
- Do not stop valacyclovir tablets or change your treatment without talking to your healthcare provider.
- Valacyclovir tablets can be taken with or without food.If you are taking valacyclovir tablets to treat cold sores, chickenpox, shingles or genital herpes, you should start treatment as soon as possible after your symptoms start. Valacyclovir tablets may not help you if you start treatment too late.
- If you miss a dose of valacyclovir tablets, take it as soon as you remember and then take your next dose at its regular time. However, if it is almost time for your next dose, do not take the missed dose. Wait and take the next dose at the regular time.
- Do not take more than the prescribed number of valacyclovir tablets each day. Call your healthcare provider right away if you take too much valacyclovir tablets.
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When Treatments For Genital Herpes Are Given
- Initial treatment. If you have symptoms such as sores when youâre first diagnosed with genital herpes, your doctor will usually give you a brief course of antiviral therapy to relieve them or prevent them from getting worse. Your doctor may keep you on the drugs longer if the sores donât heal in that time.
After the first treatment, work with your doctor to come up with the best way to take antiviral therapies. There are two options:
- Intermittent treatment. Your doctor may prescribe an antiviral drug for you to keep on hand in case you have another flare-up this is called intermittent therapy. You can take the pills for two to five days as soon as you notice sores or when you feel an outbreak coming on. Sores will heal and disappear on their own, but taking the drugs can make the symptoms less severe and make them go away faster.
- Suppressive treatment. If you have outbreaks often, you may want to consider taking an antiviral drug every day. Doctors call this suppressive therapy. For someone who has more than six outbreaks a year, suppressive therapy can reduce the number of outbreaks by 70% to 80%. Many people who take the antiviral drugs daily have no outbreaks at all.
There is no set number of outbreaks per year that doctors use to decide when someone should start suppressive therapy. Rather, more important factors are how often the outbreaks happen and if they are severe enough to interfere with your life.
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When Should You Call Your Doctor
If you havenât been diagnosed with genital herpes, call your doctor if you have:
- Painful blisters or sores in the genital or pelvic area.
- Burning or pain while urinating, or you canât urinate.
- Reason to think youâve been exposed to genital herpes.
If you have been diagnosed with genital herpes, call your doctor if you are having frequent outbreaks or if you canât pass urine or are constipated.
If you are pregnant and have genital herpes, or if you think you have genital herpes, tell your doctor.
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What Does Sti Testing Involve
STI tests may look for things like gonorrhea, chlamydia, HIV or syphilis. If you dont have symptoms, STI testing involves providing a urine sample and/or a blood sample. The urine can be tested for gonorrhea and chlamydia. The blood sample can be tested for HIV and syphilis.
If you do have symptoms, a clinician will evaluate your symptoms. The clinician may swab the symptomatic areas of your body for testing. They may also ask you to provide a urine sample and/or a blood sample. Although the clinician may be able to say whether or not you have an STI, the test can tell you for sure which STI you have, and will help identify the appropriate treatment.
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What Is Neonatal Herpes
Neonatal herpes can be a very serious infection. Babies generally contract the virus from their birthing parent during childbirth even if the parent doesnt have active lesions. They may also get HSV-1 if an adult with an active cold sore kisses them. Breastfeeding babies can also get HSV-1 from the breast if there are lesions present. But babies cant get herpes from breast milk, so its safe to pump and feed.
Herpes simplex can be more dangerous for young babies because they dont have a fully developed immune system. But most babies with neonatal herpes can recover fully with treatment.
The dangers of neonatal herpes are much higher if the infection spreads to the babys organs. If youre pregnant and have herpes, speak with your healthcare provider about how to lower the risk of passing the infection to your baby.
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What Are The Complications Of Genital Herpes
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5
There are also potential complications for a pregnant woman and her newborn child. See How does herpes infection affect a pregnant woman and her baby? below for information about this.
Herpes Average Incubation Period
Both HSV-1 and HSV-2 cause painful sores and blisters that present in five stages:
- Stage 1:About 1-2 days before the cold sore or blister appears, tingling, itching, burning, or numbing sensation starts where the outbreak will occur.
- Stage 2:One or more painful sores appear, typically around the mouth or the genitals.
- Stage 3:Several days later, the sores burst, which allows the fluid inside to escape. This fluid can easily transmit the virus to othersthis is a highly contagious time.
- Stage 4: A crust forms, covering the sores as they dry out.
- Stage 5:A scab forms over the crust, and eventually flakes off once the sore is fully healed.
From start to finish, a herpes simplex sore outbreak typically lasts 1-2 weeks.
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When Do Symptoms Appear
You must first understand how the infection works to know how long it takes for STD symptoms to appear. After coming into contact with an STD and before you start showing symptoms, your body must take the time to develop antibodies for the STD to recognize it. This period is known as the incubation period, and the length of each STD incubation period can differ.
Some STIs can take months to years to show symptoms, so taking a STD test if you think you have been exposed can be helpful even if you are not seeing any signs yet. While getting test results for an STD is helpful, sometimes you may get a false negative result even if you do have the infection if you test too early during the incubation period.
Symptoms Of Genital Herpes
Primary Genital Herpes Outbreak
For people with symptoms, the first outbreak usually occurs in or around the genital area 2 days to 2 weeks after sexual exposure to the virus. The first signs are a tingling sensation in the affected areas and groups of small red bumps that develop into blisters. Over the next 2 to 3 weeks, more blisters can appear and rupture into painful open sores. The lesions eventually dry out, develop a crust, and heal rapidly without leaving a scar. Blisters in moist areas heal more slowly than those in dry areas. The sores may sometimes itch, but itching decreases as they heal.
About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever. Swollen glands may occur in the groin area or neck. Some women may have difficulty urinating and may, occasionally, require a urinary catheter. Women may also experience vaginal discharge.
Recurrent Genital Herpes Outbreak
In general, recurrences are much milder than the initial outbreak. The virus sheds for a much shorter period of time compared to an initial outbreak of 3 weeks. Women may have only minor itching, and the symptoms may be even milder in men.
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Can You Have Herpes And Not Know It
Yes, it is possible to have herpes and not know it.
Some people may have an asymptomatic infection, which means they do not experience any symptoms. Others have symptoms that are mild, go unnoticed, or mistaken for another skin issue. Because of this, they’re less likely to seek out a diagnosis to confirm herpes.
Where Does The Herpes Virus Live In The Body
The herpes simplex viruses are latent, meaning they can live in the body without causing symptoms. After the initial infection, the virus gets into the nerve roots and spreads to the sensory nerve ganglia, the junctions where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. For orofacial herpes , the ganglia are located behind the cheek bone.
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How Long Does It Take For Herpes To Show Up After Exposure
Herpes is not just one type of infection. Its a family of related viruses that can cause several different medical conditions. The herpes infection were talking about when it comes to sex is caused by the herpes simplex virus or HSV .
Typically, HSV-1 is responsible for cold sores on the lips and around the mouth. HSV-2 is most commonly transmitted sexually and causes genital herpes, a common sexually transmitted infection . However, HSV-1 can also spread from the mouth to the genitals through oral sex and cause genital herpes.
While the symptoms of herpes usually show up anywhere from a couple of days to about two weeks following exposure, thats not always the case. In some cases, you may be asymptomatic for weeks or months before your first outbreak .
Long story short, if a few weeks have gone by after exposure and you dont have any symptoms, that doesnt necessarily mean youre out of the woods.
How Long Before The First Outbreak
If someone has contracted HSV but not yet experienced a herpes outbreak, truthfully theres no 100% accurate way to determine when one will occur. An outbreak can occur within a week of exposure, or years later.
First, consider that everyones body is different, as is their immune system. If a person has a strong immune system, then it can be possible for an outbreak to occur years after contracting the virus.
Whats more, some strains of HSV are more forceful and aggravating than others.
There is what is considered typical, and that is that people often have their first outbreak two weeks after contracting it. But this just isnt reliable, because its equally accepted that people can often have outbreaks after two years.
Thats why so many people will have trouble pinpointing when they got herpes at all. There are varied statistics and possibilities:
Stress is a common trigger for an outbreak.
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What Triggers A Herpes Outbreak
As we mentioned, following you first herpes infection, the virus lies dormant in your nerves. Your immune system usually keeps it at bay.
But your immune system can only deal with so much at once. That means if you have dormant herpes and your immune system needs to fend off another virus or bacteria, it may get distracted, allowing herpes to crop up. Thats why cold sores are called cold sores or fever blistersthey typically appear when you catch another bug .
Different types of stress can also trigger outbreaks. Psychological stress, especially the stress caused by extreme emotional upset, can lead to an outbreak .
Things that cause physical stress can also contribute. Sunlight is a common trigger of oral herpes outbreaks, while friction from tight clothing or sex, and even hormone changes associated with menstruation, are common triggers of genital herpes outbreaks .
Speak to a healthcare provider about your options and which treatments might be effective for preventing or shortening your outbreaks.
Is There A Cure For Herpes
Not all of the symptoms of herpes show up on the skin. Other symptoms can include :
- Fever or flu-like symptoms
- Swollen lymph nodes
- Painful urination
Before any of these herpes symptoms show up, the very first sign may be something called a prodrome. This refers to tingling, itching, pain, or burning on the parts of your skin that were exposed to the virus .
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How Has My Partner Caught Genital Herpes
If your partner has only just been diagnosed with genital herpes, this does not necessarily mean that they have been unfaithful to you or sexually promiscuous in the past.
- Your partner may have caught genital herpes from you. You can carry the virus without knowing you have it as some people have no symptoms.
- It is also possible that your partner caught the virus from a cold sore on your mouth or face during oral sex. You can pass the virus on even if you dont have a cold sore at the time of contact.
- Your partner may have contracted the virus from a previous sexual partner, even several years ago. The virus can remain inactive in your body for long periods.
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Ruling Out Conditions That Resemble Oral Herpes
Simple canker sores are often confused with the cold sores of HSV-1. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue. Their cause is unknown, and they are common in perfectly healthy people. They are usually white or grayish crater-like ulcers with a sharp edge and a red rim. They usually heal within 2 weeks without treatment.
This aphthous ulcer is located in front of and just below the bottom teeth.
Oral candidiasis is a yeast infection that causes a whitish overgrowth in the mouth. It is most common in infants, but can appear in people of all ages, particularly people taking antibiotics or those with impaired immune systems.
Other conditions that may be confused with oral herpes include herpangina , sore throat caused by strep or other bacteria, and infectious mononucleosis.
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