A forty year old, Hispanic female, came into my office last week with open sores and blisters on her lips and inside of her mouth. Patient said that her boyfriend has the same sores and blisters on his mouth and she may have exposed herself to his open sores. I took a culture of one of the sores that was open. The results showed that she had the herpes simplex virus, type one, known as fever blisters. I informed her that the virus usually invade the moist membrane cells of the lips, throat, or mouth. The blisters tend to combine and then disintegrate. Usually a yellowish crust will cover the sores, which should heal without scarring within two weeks. However the virus does not leave the body once you have been infected with oral herpes, it remains in a nerve positioned near the cheekbone. The patient then asked what causes an out break to return. I told her that emotional stress, fever, illness, injury, or prolonged exposure to sunlight, weaken her body’s defense against an outbreak. She then asked what she can do to prevent the recurrence of the fever blister. I told her to keep them clean and dry, eat a soft diet to avoid irritating the sores. I let her know that the virus is very contagious and she avoid touching the open sores and then having skin contact with other people. There is no cure for the herpes virus but I suggested the use of ointments that numb the blisters such as Orajel, or creams that prevent and relieve the sores such as Denavir.
A twenty year old, Caucasian male, came into my office yesterday complaining of a stinging and blisters around his genital area. He also has had flu-like symptoms such as headaches, fever, and swollen gland for the past week. I then took a culture of an open sore on his genital. The results came back showing that he had Herpes Simplex Virus, type two. I informed him that the virus is almost always sexually transmitted and is extremely common: about 1 in 5 Americans over the age of twelve have it. After the first outbreak occurs, the herpes virus can lie dormant in nerve cells in the body for weeks, months, or even years. Stress, illness, sexual intercourse, and prolonged sun exposure may cause another outbreak. Unfortunately, no one can predict when another outbreak will occur. The patient then asked what he can do to prevent passing it on to others. I told him to avoid any sexual activity during an outbreak, and when you suspect one may be starting. Unfortunately even when you have no symptoms of genital herpes you may still pass the virus on; therefore, you should always use a latex condom during sex. Although latex condoms do not guarantee that the virus will not be passed on to your partner. The patient then asked if there is a cure for the virus. I replied by telling him that there is no cure for genital herpes; although fortunately it can be treated effectively with medication. I gave him a prescription medicine called Famvir which is proven to shorten the duration of burning, pain, itching, and tenderness associated with the herpes sores.
A twenty-five year old, Caucasian female, came in to my office today and told me that she has been diagnosed with genital herpes and is thinking about having a child, but wanted to know if it would be safe for the child. I told her that it was a good idea to consult with me first because there are many factors that may concern the safety of the baby and the factors vary depending on the women. I explained to her that many women with genital herpes have healthy babies and infecting an infant with genital herpes is very rare. Women who have herpes before becoming pregnant are not likely to pass the virus to the baby because they protect the baby by passing antibodies to it during the pregnancy. She then asked me if women who have herpes are able to have a normal vaginal delivery. I then explained to her that the majority of women with genital herpes are able to deliver the baby vaginal with not complications. However it is possible for the baby to be exposed to the herpes simplex virus through vaginal deliveries and in some cases may cause brain damage to the infant; therefore it often recommended that women with active genital herpes have a c-section or caesarean section to be on the safe side. I also informed her that there are several anti-herpes medications that are sometimes taken during pregnancy in order to provide extra protection for the baby although she should consult with me first before taking these medications to be sure that they are safe for her. I then reassured her again that she and the child would be perfectly healthy in the end and the herpes simplex virus would not affect the child.
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Herpes Simplex 1
It is one of the most common infections in the world. Over 80 percent of the population has it. It is Herpes Simplex. Herpes is the disease caused by the virus Herpes Simplex Virus (HSV-1), commonly known as cold sores or fever blisters.
Symptoms of HSV-1 include; small fluid filled blisters around edges of lips, tingling or burning around mouth and nose (often before blister appears), fever, sore throat, and swollen lymph nodes. The virus uses DNA to attack it’s host cell. At initial infection the virus goes through a lytic life cycle, after the initial infection that causes an outbreak of sores, the virus enters the nerve cells of the body and waits to be triggered again. While in nerve cells in lower spine it carries out a lysogenic life cycle. In its lysogenic life cycle it stays in chromosomes of its host cell and replicates with it, when it is ready it goes through lysis and you have an outbreak.
The virus has a polyhedral shape, meaning it has an envelope. It’s core is made of a double stranded DNA genome. The core is surrounded by a protein cage called the capsid. The capsid is surrounded by a lipid bilayer called the envelope. The virus is a polyhedral. HSV-1 can spread through saliva, sharing of utensils, kissing, and oral sex.
The virus attacks nerve cells where it lives for the life time of an individual. It stays in the nerve cells during the lysogenic cycle. When triggered the virus uses the nerve ending in the area it wants to affect, such as the area surrounding the lips, to enter the lytic cycle, and cause an outbreak. There is no cure for HSV-1. Once you are infected with it you have the disease for life. You may have a varied number of outbreaks, and can sometimes have the disease but never have an outbreak. 30 percent of people infected with HSV-1 show no symptoms.
It is scary to think that you could not only have have a terrible disease and not know it, but be spreading it to others.