Herpes in the mouth
A herpes infection in the oral cavity – also called stomatitis aphtosa or stomatitis herpetica – is a characteristic inflammation of the oral mucosa and is caused by an initial infection or reactivation with the herpes simplex virus type 1. Children between the ages of 1-3 years are most frequently affected, as this is the preferred age for a first virus infection (transmission for example through lip contact with an infected parent; the child’s immune system is not yet fully developed, the virus passes more easily through the body’s defenses). This topic may also be of interest to you: Viral infection An initial infection – in the absence of infection in infancy – is nevertheless also possible over any other age group.
After the first virus contact, after a latency period of 3-7 days without symptoms (incubation period), a pronounced, painful inflammation of the entire mouth and throat mucosa occurs, often accompanied by fever and swollen lymph nodes in the head and neck area and general symptoms of the disease. The inflammatory reddened mucous membrane of the mouth shows the typical blisters that break open after some time (aphtae) and can cause considerable pain when eating, drinking and swallowing.However, not every initial infection proceeds with the same intensity; in some cases, uncomplicated, low involvement of individual mucosal areas can occur. As a rule, the initial infection is much more severe than the later reactivation, in which often only blisters appear on the lip.
Herpes by body region
Herpes genitalis belongs to the infectious diseases of the male and female reproductive organs and is caused by the herpes simplex virus type 1 (in 20-30%) and type 2 (in 70-80%). The transmission of the type 2 virus is usually caused by a transfer of body fluids during unprotected sexual intercourse, whereas the infection with type 1 in the genital area is transmitted to the sexual organs through active lip herpes (oral sex, smear infection via the hands). Other possibilities of infection, but these are rather rare, are direct infection via virus-carrying objects (condoms used, underwear worn) or infection of a newborn baby when passing through the birth canal during vaginal birth if the mother has active genital herpes at that time.
Typical symptoms of genital herpes are the characteristic blisters on the skin and mucous membrane of the genital organs, which can be accompanied by burning and itching (preferably on the glans, foreskin, labia and buttocks). Like the lip herpes, they subside with or without therapy (local or oral antivirals such as Aciclovir) after some time, but genital herpes also tends to recur and thus returns after an indefinite period. A manifestation of the herpes disease in or around the eye is usually caused by the herpes simplex virus type 1, although the eye is a less frequent site for reactivation of the chronic viral disease.
The eye infection can be triggered by reactivation of the herpes virus there or by a smear infection of a contagious herpes outbreak, for example on the lips or nose. Often only one eye is affected at the beginning, but the other eye can also become infected in the course of the disease. The eyelids, the cornea, the conjunctiva or the choroid of the eye can be affected.
A superficial herpes reactivation on the eyelids becomes noticeable by the appearance of small herpes blisters on the eyelid, an infection of the cornea (Herpes corneae), in which the conjunctiva is often involved (keratoconjunctivitis) with the typical symptoms of corneal or conjunctivitis: reddened eyes, increased tearing, foreign body sensation, photophobia and deterioration of vision. The herpes virus can only affect the superficial corneal layer or can also penetrate into deeper corneal layers, whereby there is a risk of infection passing into the interior of the eye (e.g. to the choroid). Deeper corneal infections carry the risk of corneal scarring and clouding and permanent visual impairment, choroidal infections even the risk of blindness.
The typical symptoms of a reactivated herpes infection can affect other parts of the body in addition to the classic infection sites such as the lips, mouth and genitals. This occurs whenever the viruses are transmitted by droplet or smear infection to possibly minimally pre-damaged skin/mucosa areas. For example, an independently caused infection of the nose can occur when one’s own hands come into contact with the contents of the broken blisters of a currently active cold sore and these then transfer the pathogens to the mucous membrane of the nose (the same applies to the eye).
The infection is always favored when the mucous membrane to which the virus is transmitted is pre-damaged (the smallest, invisible micro-injuries are usually sufficient). The appearance of nasal herpes (Herpes nasalis) is very similar to that of lip herpes, as the characteristic blisters also form in the skin and mucous membrane of the nose, which are accompanied by burning, a feeling of tension and itching and break open as the infection progresses. In addition to a severe form of the disease with necroses (dead tissue) and ulcers, there are also some other organs involved.
In the course of the disease, the eyes may be involved: a so-called eye herpes. Conjunctivitis and corneal inflammation are common. It can lead to scarring and thus to deterioration of vision.
This complication is therefore to be taken very seriously.Eczema hepeticatum can also occur. This is a HSV – superinfection of an atopic eczema (atopic eczema = neurodermatitis). This means that neurodermatitis is additionally infected with the herpes virus.
The appearance has herpes blisters in addition to the atopic eczema (nerodermitis). The distribution is extensive according to the neurodermatitis. Spontaneous healing occurs after several weeks.
A further complication is herpes simplex encephalitis, i.e. an inflammation of the brain. This form of encephalitis is the most common viral encephalitis. In general, the course is more severe in people with a weakened immune system than in healthy people.
For example, AIDS patients often suffer from tissue-destroying changes in the skin and mucous membranes, which heal only with difficulty. Conjunctivitis and inflammation of the retina also occur. There is also an involvement of the meninges (meningitis). This form of the disease is called a generalized course, since the reactions to the virus do not occur locally at one site, but are manifested in several organ systems.
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