Encephalitis

Encephalitis in an acute inflammation of the brain. Caused by herpes simplex virus, encephalitis causes cerebral edema thereby destroying nerve cells. This may lead to bleeding in the brain and brain damage. Encephalitis is often caused by the virus that causes mumps, measles, rabies, polio and rubella. Symptoms of encephalitis may begin with a stomach infection, headache and fever. It can also manifest in vomiting, drowsiness and clumsy gait. Severe headache and muscle or loss of consciousness are severe symptoms.

Brain MRI and CT scan of the head might be necessary to diagnose encephalitis. Serology tests and lumbar puncture and CSF examination might be done. Examination of the patient might show increased intracranial pressure, abnormal reflexes and mental confusion. The patient is given nutrition through fluids and anti-viral medicines such as acyclovir and foscarnet. Anti-seizures might be given. Antibiotics are prescribed in case the infection is caused by bacteria.

Herpes Blood Test

Blood tests to diagnose the presence of herpes virus antibodies can be done even if the patient does not have any visible symptoms. The standard available tests are not recommended since they are not very accurate. There is a potential for false positive results. A type specific virus culture will give an accurate result only when the sores have not healed. Herpes Simplex Virus (HSV-1) and HSV-2 are the most common viruses diagnosed using type-specific blood tests. There are three methods available to diagnose herpes - Cell Culture, Antigen test and Pap Smear test.

Herpes Western Blot Test: A more sensitive test than the viral culture is the Gold Standard test known as PCR DNA test. This test also known as Herpes Western Blot test, which is rated as an accurate test to identify DNA for viral particles which easily differentiates the two types, viz. type-1 and type-2. This test can be carried out safely during pregnancy. A wide range of antibodies that respond against many herpes simplex virus proteins are tested in Western Blot test.

BIO-KIT or POCKit TEST: Recently, a more accurate POCKit type-specific test has been approved by FDA (Food and Drug Administration) to diagnose herpes simplex virus-2. A doctor's office can do this Point Of Care (POCKit) test and provide results in just 10 minutes. This new test is cost-effective and less time consuming. A positive HSV-2 test result confirms genital infection. Sensitivity in this test is around 96% accurate. Using this test during pregnancy is not approved by FDA.

ELISA ,Immunoblot and IgG type specific Elisa are the other three tests carried out to diagnose HSV-1 & HSV-2 types with the sensitivity ranging from 96% - 100%. Blood drawn from the patient's arm is sent to local labs and the results are available in a fortnight.

Herpetic Whitlow

Herpetic Whitlow is a painful skin infection of the hand and fingers. In this condition, the base of the nail or pulp of the finger is afflicted with a small painful abscess that are pus filled. This skin infection is caused by Herpes simplex virus. It is characterized by intense pain in the affected finger. While herpetic whitlow usually begins in one finger,the other fingers soon get affected. In severe cases, the person may lose the affected nail or suffer disfigurement of the finger. There is intense pain when the abscess bursts. There may be itching, swelling and tenderness in affected area.

Secondary infection can lead to fever and swollen glands in the armpit. Herpetic Whitlow tends to affect housewives whose hands are wet for long periods due to washing and cleaning. It is also noticed among healthcare workers. Use of latex gloves while working with cleaning agents, scouring powders and detergents can help in keeping this infection at bay. Children and adults must keep the hands clean and dry. Herpetic whitlow is treated with oral anti viral agents such as Acyclovir. Topical steroid creams or ointments are applied.