1/13. Severe intrauterine herpes simplex disease with placentitis in a newborn of a mother with recurrent genital infection at delivery.We present a case of fatal herpes simplex type 2 (HSV-2) in a premature infant born to a mother diagnosed with recurrent HSV-2, based on history and HSV serology results. It was clinically evident at delivery, and subsequently confirmed by laboratory studies that the infant was infected before delivery. There was histopathologic evidence of placentitis and chorioamnionitis upon examination of the placenta and fetal membranes. This case illustrates a relatively uncommon complication of recurrent genital herpes at delivery--intrauterine transmission to the fetus from a primary episode during pregnancy.- - - - - - - - - - ranking = 1keywords = membrane, pregnancy (Clic here for more details about this article) |
2/13. Fetal demise due to herpes simplex virus: an illustrated case report.We report and illustrate a case of fetal demise at 31 weeks caused by fulminant herpes simplex virus (HSV) infection. The 15-year-old mother reported no past history or symptoms of an HSV infection during pregnancy. autopsy revealed extensively ulcerated skin and necrosis of the liver, adrenal glands, brain, and placental membranes. Fluorescent in situ hybridization studies of the lungs, liver, adrenal glands and placenta were positive for HSV, but did not distinguish between HSV-1 and HSV-2. A maternal postpartum blood sample was positive for HSV-2 by immunoblot assay.- - - - - - - - - - ranking = 1keywords = membrane, pregnancy (Clic here for more details about this article) |
3/13. Case study: type-specific HSV serology and the correct diagnosis of first-episode genital herpes during pregnancy.It is now known that the physical presentation of genital herpes simplex (HSV) infection can be misleading in making the diagnosis of genital herpes. An incorrect diagnosis can be particularly damaging in pregnancy where it may result in extended exposure of the fetus to antiviral agents, an inappropriate route and timing of delivery and a significant increase in fetal exposure to HSV during labour and delivery. Case 1 describes a 32-year-old woman at 30 weeks in her first pregnancy who had the appearance and clinical course typically ascribed to primary genital HSV infection. In contrast, Case 2, a 24-year-old woman at 34 weeks' gestation, had the physical appearance of a recurrent episode. Type-specific serological testing revealed that what Case 1 was actually experiencing was the first symptomatic reactivation of genital herpes, whereas Case 2 had a true primary genital HSV-2 infection that was accompanied by minimal symptoms. Had serology testing not been available, Case 1 would probably have delivered unnecessarily by Caesarean section, and Case 2 would have been managed as a recurrent infection and allowed to deliver vaginally with potentially disastrous results. These cases illustrate the usefulness of a type-specific serology in diagnosing genital herpes in pregnant women.- - - - - - - - - - ranking = 2.6164490435275keywords = pregnancy (Clic here for more details about this article) |
4/13. acyclovir treatment of primary herpes in pregnancy complicated by second trimester preterm premature rupture of membranes with term delivery: case report.Primary genital herpes simplex virus (HSV) infection in pregnancy is associated with an increased risk of vertical transmission to the fetus, especially with rupture of membranes. Two cases of primary herpes and two cases of recurrent herpes in pregnancy with preterm premature rupture of membranes and expectant management have been reported, all delivering preterm. We report a case of primary maternal genital HSV infection with preterm premature rupture of membranes at 24 weeks' gestation who subsequently went on to deliver at term. This case was managed with intravenous acyclovir. Neonatal serology for HSV I (immunoglobulin m [IgM] and IgG) and HSV II (IgM) were negative. antibodies for HSV II (IgG) were positive. Subsequent 6-month follow-up titers were negative for all herpes antibodies. On the basis of an extensive search of the English literature from 1966 to 2001, this is the first reported case of primary herpes in pregnancy associated with preterm premature rupture of membranes with a subsequent term delivery.- - - - - - - - - - ranking = 22095.494981643keywords = premature rupture, membrane, pregnancy, rupture (Clic here for more details about this article) |
5/13. Acute fatty liver of pregnancy -- an underlying condition for herpes simplex type 2 fulminant hepatitis necessitating liver transplantation.The infrequent occurrence of herpes simplex virus (HSV) hepatitis in healthy women in comparison with the high prevalence of HSV infections suggests that, in addition to deranged immunity, an underlying condition in the liver might be necessary to develop HSV hepatitis. We report the case of a 28-year-old pregnant woman in the 28 (th) week of gestation. Following HSV type 2 infection of the uterine cervix, acute liver failure developed, necessitating urgent liver transplantation. In addition to fulminant HSV type 2 hepatitis, the explanted liver also showed the histological features of acute fatty liver of pregnancy. The presented case suggests a possible pathogenetic role of acute fatty liver of pregnancy in the development of fulminant HSV hepatitis following recurrent infection with HSV in healthy pregnant women. We believe that early histopathological diagnosis, followed by specific antiviral treatment and liver transplantation in selected patients may improve the clinical outcome of otherwise almost uniformly fatal HSV hepatitis.- - - - - - - - - - ranking = 2.6164490435275keywords = pregnancy (Clic here for more details about this article) |
6/13. Replication characteristics and core size of intranuclear herpes simplex virus (HSV-1) in genital skin lesions: electronmicroscopy studies of a biopsy from a female patient.herpes simplex virus (HSV) type 1 genital infection, leading to ulcerating lesions in a female patient, was studied by electronmicroscopy. infection had probably been recent, through oro-genital contact with a cold sore on the husband's lip. Cell-culture typing and serological tests indicated that the patient currently had an HSV-1 secondary infection. Aspects studied in a skin biopsy from an ulcerating labium majus were epidermal cell types infected, stages in virus genesis, virus core diameter in intranuclear capsids and extracellular appearance of virus. Different stages in virus genesis, in virus envelope formation and in nuclear and cytoplasmic degeneration were observed in the few remaining, rounded and swollen, epidermal (?) spinosum cells. Their nuclei, some with marginated chromatin, harboured besides dense-cored or empty capsids, electron-dense blobs possibly representing clones of immature virus and falling apart into aggregates of small granules. In other nuclei, large clusters of dense-cored capsids, some distinctly hexagonal in shape, had accumulated in wide gaps in the nuclear membrane whereas remaining nuclear membrane portions were quadruple and often engaged in viral envelope formation. Partially enveloped capsids and naked dense-cored capsids were seen extracellularly indicating their survival outside cells. An occasional virion was present in dermal blood vessel lumina. Measurements of the electron-dense core (nucleoid) of intranuclear capsids in electronmicrographs showed that the HSV-1 core diameter differs very significantly from the core of intranuclear HSV-2 capsids, thus allowing a clear distinction by electronmicroscopy between the two HSV subtypes in plastic-embedded biopsies.- - - - - - - - - - ranking = 1.1278503188242keywords = membrane (Clic here for more details about this article) |
7/13. Maternal herpes infection complicated by prolonged premature rupture of membranes.Three cases of patients who developed genital herpes virus infections after prolonged, premature rupture of membranes (PROM) at 28-31 weeks gestation are reported. These patients were expectantly managed without immediate intervention at the time of diagnosis of the genital herpes virus infection. In all three cases, there was no evidence of neonatal herpes virus infection at the time of delivery or before hospital discharge. The spectrum of decisions facing the physician managing a patient with prolonged PROM and a genital herpes virus infection is discussed, and a rational approach to management presented.- - - - - - - - - - ranking = 15779.717060059keywords = premature rupture, membrane, rupture (Clic here for more details about this article) |
8/13. Neonatal herpes simplex virus infection occurring in second twin of an asymptomatic mother. Failure of a modern protocol.A case of neonatal herpes that occurred after vaginal delivery in the absence of genital lesions is presented. The mother had a history of drug addiction and genital herpes. Asymptomatic shedding of herpes simplex virus type 2 from the cervix was noted in the second trimester of pregnancy. Despite being followed with a protocol of close surveillance and serial culturing of the genital tract, the patient gave birth to twins, one of whom developed herpes simplex virus type 2 in the postpartum period. This report presents discussion of this case and herpes surveillance protocols.- - - - - - - - - - ranking = 0.43607484058792keywords = pregnancy (Clic here for more details about this article) |
9/13. Management of primary herpes in pregnancy complicated by ruptured membranes and extreme prematurity: case report.A case of primary herpes simplex vaginitis during pregnancy became complicated by rupture of membranes at 25.5 weeks' gestation. The patient was treated with intravenous acyclovir shortly after rupture, and managed expectantly. Genital lesions rapidly abated, and the infant was delivered by cesarean section at 26.5 weeks' gestation after labor ensued. Transplacental passage of acyclovir was documented. The infant then was treated with a ten-day course of intravenous acyclovir. The infant has remained culture negative for 12 months after delivery.- - - - - - - - - - ranking = 6.647891096609keywords = membrane, pregnancy, rupture (Clic here for more details about this article) |
10/13. Retention of urine in genital herpetic infection. Survey and case report.During the last years several cases of acute urinary retention, due to genital herpetic infection, have been described, especially in youngsters. The condition is caused by neurogenic dysfunction due to a sacral meningomyelitis. The clinical picture before the acute attack is characterized by painful genital eruptions; fever and malaise; tender inguinal lymph nodes; paresthesia in the perineum and on the inside of the thigh, and obstipation. skin and mucous membrane manifestations are often sparse or located so that they are easily overlooked. The treatment is bladder drainage until the patient is able to void spontaneously. Most of the patients regain normal bladder function within 10 days, but bladder dysfunction for 5 weeks has been described. We present a typical case of acute urinary retention due to genital herpetic infection.- - - - - - - - - - ranking = 0.56392515941208keywords = membrane (Clic here for more details about this article) |
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