Herpes Simplex Virus, Disseminated
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054.5 – Herpetic septicemia
B00.7 – Disseminated herpesviral disease
SynopsisInfection with herpes simplex virus type 1 or herpes simplex virus type 2 (HSV-1 or HSV-2) usually presents as discrete groups of painful vesicles on orolabial or genital skin. However, in some instances, HSV infection may be diffuse, involving multiple sites of the body. When multiple regions of skin and/or internal viscera are concomitantly infected, the disease is termed disseminated HSV.
Clinically, disseminated HSV presents as a widespread eruption of vesicles, pustules, and/or erosions. Constitutional symptoms often occur and commonly consist of fever and regional lymphadenopathy. Most patients recover without adverse event, but progression to fatal disease can occur.
Two general groups of patients are at risk to develop disseminated HSV: patients with underlying skin disease and immunocompromised patients. Pregnant women with primary HSV infection are at increased risk for severe illness, ie, dissemination and hepatitis, particularly in the third trimester.
Acute generalized infection of previously damaged skin with HSV is known as eczema herpeticum or Kaposi varicelliform eruption. This clinical picture may be seen in all age groups, but it most commonly occurs in the second and third decades. Most cases are due to HSV-1, but HSV-2 is also reported. Atopic dermatitis is the most common preceding condition, but the condition may also be seen in patients with various other underlying skin conditions such as Darier's disease, pemphigus foliaceus, pityriasis rubra pilaris, Hailey-Hailey disease, congenital ichthyosiform erythroderma, mycosis fungoides, and patients with burns.