单纯疱疹病毒-课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单纯疱疹病毒 ppt课件,单纯疱疹病毒 ppt课件,1,Neonatal Herpes Simplex Infection,Neonatal Herpes Simplex Infect,2,INTRODUCTION,Discovery of neonatal Herpes Simplex virus (HSV) in the 1930s,Neonatal infection with HSV occurs in 1/3200 to 1/10,000 live births,In China,，,2/10,000 to 5/10,000,INTRODUCTIONDiscovery of neona,3,VIROLOGY,HSV is a DNA virus,HSV-I, HSV-II,HSV-II associated with poorer outcome,VIROLOGY HSV is a DNA viru,4,TRANSMISSION,HSV enters human host through inoculation of oral, genital, or conjunctival mucosa or break in skin,TRANSMISSIONHSV enters human,5,1.Intrauterine,2.,Perinatal,3.,Postnatal,1.Intrauterine,6,Maternal viremia,Ascending infection,Usually after prolonged rupture of membranes,Intrauterine,Maternal viremiaIntrauterine,7,2.,Perinatal,-,HSV infection is present in the genital tract of pregnant woman at time of delivery,-,Most common mode (85%) of neonatal HSV infection,2. Perinatal,8,3.,Postnatal,-,When active HSV infection has close contact with the newborn,3. Postnatal,9,intrauterine,5%,perinatal 85%,postnatal 10%,intrauterine 5%,10,CLINICAL MANIFESTATIONS,-,Skin, Eye, Mouth,-Central Nervous System,-Disseminated Disease,CLINICAL MANIFESTATIONS-Skin,11, 90% present between 5-19 days of age, 20% NEVER have skin lesions,Initial symptoms vague in 30%,Lethargy,Poor feeding,Fever,Irritability, 90% present between 5-19 day,12,skin,-Usually presents in the first two weeks of life,-clustering vesicular lesions with an erythematous base,skin-Usually presents in the f,13,单纯疱疹病毒-课件,14,Eyes-,1.Excessive watering of the eye,2.Crying from apparent eye pain,3.Conjunctival erythema,4.Periorbital skin vesicles,5.Can progress to cataracts and chorioretinitis, permanent vision loss,Eyes-1.Excessive watering of t,15,单纯疱疹病毒-课件,16,Mouth,-Localized ulcerative lesions of the mouth, palate, and tongue,Mouth-Localized ulcerative les,17,CNS Disease,1/3 of neonatal HSV disease involves the CNS,Presents in second-third week of life,Irritability,Tremors,Poor feeding,CNS Disease1/3 of neonatal HSV,18,HERPES ENCEPHALITIS,HERPES ENCEPHALITIS,19,of HSV disease is in the disseminated form,Present in the first week of life,Affects: liver, lungs, adrenals, CNS, skin, eyes, and mouth,DIC,Disseminated Disease,Disseminated Disease,20,单纯疱疹病毒-课件,21,Diagnosis of Neonatal HSV Infection,Gold standard = Positive culture of: lesion, nasopharynx, conjunctiva, rectum, or CSF,Rapid diagnostic methods,Polymerase chain reaction on CSF and blood,Fluorescent antibody stain on vesicle scraping,Diagnosis of Neonatal HSV Infe,22,EEG,Brain Imaging,Chest Radiograph,May demonstrate bilateral, diffuse,pneumonia,Abdominal US,May demonstrate ascites and/or enlarged liver in neonates with HSV hepatitis and acute liver failure,EEG,23,TREATMENT,Acyclovir is the treatment of choice,Dose,-skin eye mouth infection,60mg/kg/day divided q8h for 14 days,May be lengthened to 21 days in the near future,Dissiminated and CNS HSV infections,60mg/kg/day divided q8h for 21 days,TREATMENTAcyclovir is the trea,24,INFECTION CONTROL STEPS,Pregnant women primary or first episode: Acyclovir therapy at 36 wk 400mg tid,Primary HSV in 3,rd,trimester: C-section should be offered,Hand washing before and after care of infants,Mother with lesions on hands hand hygiene and gloves,INFECTION CONTROL STEPSPregnan,25,references,Neonatal Herpes Simplex Virus Infection: Clinical Features and Diagnosis.,UptoDate. Demmier-Harrison, Gail MD,Neonatal Herpes Simplex Virus Infection: Management and Prevention.,UptoDate. Demmier-Harrison, Gail MD,Neonatal Herpes Simplex Virus Infections,. American Family Physician. Rudnick, Caroline MD, Hoekzema, Grant MD. 03/15/2002, 1138-1142,referencesNeonatal Herpes S,26,单纯疱疹病毒-课件,27,