Title: Physeo / 12 - Microbiology / 05 - Viruses / Section 1 - Herpes Simplex Virus-1 (HSV-1) and Herpes Simplex Virus-2 (HSV-2)
Tags: Physeo::Microbiology::Viruses::HSV

Herpes Simplex Virus (HSV) is a icosahedral linear enveloped dsDNA virus
Extra: Viruses are enveloped unless indicated otherwise
DNA virus images = dark colors (blue and purple)
RNA virus images = warm colors (red yellow and orange)
Two loyal snakes moving directly parallel to another = HSV is double-stranded
All DNA viruses are double-stranded (except parvovirus)
Most of the RNA viruses are single stranded
Pathway to Zeus’s Temple is a straight line = the straight line is here to help you remember that HSV is linear

Q: HSV-1 is transmitted primarily through [...]
A: respiratory droplets
Extra: Mist = Respiratory droplets

Q: HSV-1 remains latent in the [...] ganglion
A: trigeminal
Extra: Belt with 3 gems on it = tri
Gems = geminal
Image shows rigeminal ganglion epicting many of the nerves in the face then you can see the trigeminal emanating from the trigeminal ganglion which is right here
ganglion = cluster of nerve cells → ganglia are noticed as a swelling in a nerve
*very high yield for you to know that this is a sensory ganglion*

HSV-1 may precipitate as bichcet syndrome, a type of vasculitis characterized by genital and oral ulcers, uveitis, and erythema nodosum

Q: HSV-1  can cause [...] this is a condition characterized by ulcers affecting the gingiva and sometimes the surrounding structures such as the [...] and the [...]
A: gingivostomatitis; lips; hard palate

Q: HSV-1 can cause [...] which is where there is inflammation of the [...] and the [...]
A: keratoconjunctivitis; cornea; conjunctiva
Extra: Keratitis = inflammation of the cornea
conjunctivitis = inflammation of the conjunctiva
keratoconjunctivitis
This is an image of viral keratoconjunctivitis as you can see that clearly inflamed but the cornea can’t be very well visualized unless special dyes are used so this can be a bit harder to see regardless this patient was confirmed to have viral keratoconjunctivitis

Q: [...] which is a painful dermatological condition associated with [...] that affects the [...]
A: Herpetic Whitlow; HSV-1; fingers
Extra: Hercules was lifting up a bloody finger into the air
This is an image of herpes herpetic whitlow, as you can see this patient appears to have several vesicles on an air them in a space that is isolated to the finger right here typically herpetic Whitlow presents as a single vesicle or a cluster of vesicles on the finger

Q: HSV-1 can cause [...] which is an infection that affects the [...]
A: herpes labialis; lips
Extra: Blood on the snake lips = herpies labialis
this is an image of herpes labialis and as you can see it’s characterized by a painful vesicular lesion that occurs on or adjacent to the lip

Q: HSV-1 can also cause [...] a which is a distinctive rash that results in [...] like lesions on the skin
A: erythema multiforme; target
Extra: Bite marks on Hercules arm = erythema multiforme
 an image of erythema multiforme affecting an infant. As you can see, the rash results in erythemitous Target like lesions. This is a self-limiting condition and typically only last a few days

Q: HSV-1 can cause [...], which results in a red appearing retina
A: retinitis
Extra: Hercules stabbing one of the snakes in the eye with a sword = retinitis

Q: HSV-1 can cause [...], a GI compication
A: ulcerative esophagitis
Extra: bunch of craters in the ground = ulcers in the esophagus
This is an endoscopic image of HSV causing ulcerative esophagitis as you can see the ulcers are somewhat superficial and occur all over the esophagus

Q: HSV-1 can cause [...] lobe [...]
A: temporal; encephalitis
Extra: Temple on fire = inflammation of the temporal lobes of the brain
 this is an MRI of temporal lobe Encephalitis as you can see there is pretty obvious enhancement of the temporal lobes right here

Q: Unlike HSV-1,  HSV-2 is [...] transmitted
A: sexually
Extra: scarlet letter s symbol = sexual transmission

Q: HSV-2 mostly affects the parts of the body [...] to the ground for example the [...]
A: lower; genitals
Extra: Guy being closer to the ground, lower half of the body affected by HSV 2

Q: Herpes is a [...] infection and can cause [...]
A: TORCHES; neonatal herpes
Extra: guy is holding a torch up = herpes is a torches infection

Q: While HSV-1 and HSV-2 can both cause neonatal herpes, its most commonly associated with [...] as a baby passes through the birth canal of an infected mother
A: HSV-2
Extra: Guy representing HSV-2 holding the torch
this is an image of neonatal herpes on the scalp of a newborn

Q: [...] can cause painful vesicular [...] lesions
A: HSV-2; genital
Extra: Crotch up in flames = painful vesicular genital lesions
 this is an image of the characteristic vesicular and ulcerative lesions of herpes affecting the female genitalia

Q: HSV-[...] can cause [...] lymphadenopathy
A: 2; inguinal
Extra: little green beads to this guy’s tunic Ruffles (symbols of lymphatic system) are by inguinal area = inguinal lymphadenopathy

Q: Compared to HSV-1, HSV-2 is more commonly associated with [...]
A: meningitis
Extra: Torch guys hat on fire = inflammation of the meninges

Q: HSV-[...] remains dormant in the [...] neural ganglia
A: 2; sacral
Extra: sac  = sacral

Q: HSV can be diagnosed using [...]
A: PCR
Extra: Zeus's 3 chain weapon = polymerization reaction
If a patient has a herpes skin lesion a swab can be obtained and then PCR can be performed
If there is neurologic involvement such as meningitis or temporal lobe encephalitis then PCR of the CSF should be performed

Q: [...] for diagnosing HSV is considered the gold-standard but other older techniques such as the [...] can also be used
A: PCR; Tzanck smear

Q: The scrapings of the HSV lesions can be performed on patients with active lesions and a special stain or smear known as the [...] can be used to detect [...]
A: Tzank smear; multinucleated giant cells
Extra: Zeus's giant hammer = multinucleated giant cells
this is an image of a tzanck smear as you can see there are three multinucleated giant cells in the center of the image right here this multinucleated process is thought to occur as a virus rapidly replicates in the host cell nucleus which results in abnormal cellular division

Q: [...] are [...] look inclusion bodies associated with [...] that may be seen under the microscope
A: Cowdry a inclusions; eosinophils; HSV
Extra: The stray cow in the cyclone
this is an image of cowdry bodies Within hepatocytes you can see that you sent it feel inclusion for example right here

Q: HSV can be treated with [...], [...], [...]
A: acyclovir; valacyclovir; famciclovir
Extra: Cyclone = acyclovir
Violet Cyclone = valacyclovir
Little mini Cyclone from the fan = famciclovir