Genital herpes in children: routes of infection, photos and treatment

What is genital herpes?

Genital herpes is one of the serious infectious diseases. The center of this disease is in the nerve cells of almost all organs. This fairly common disease belongs to the venereological group. This pathology is not hereditary.

Genital herpes is transmitted sexually, through kissing, and through shared objects (cutlery, toys, personal hygiene items). It is important to note that most infected people do not notice any symptoms at all. They may not realize that they pose a danger to others.

The incubation period of herpes is 7 days. The infection reaches its peak in one and a half months. The disease is prone to persistent progression with relapses. Symptomatic elements of the rash can be located grouped or separately. These are small blisters that appear on the swollen and reddened base of the mucous membrane of the genitourinary system, as well as on the skin of the perineum.

Here you will find a similar article on the topic of herpes on the body.

Genital herpes in children

Newborn babies have very weak immunity, so the disease can manifest itself in the first week after birth. The main signs are the appearance of hemorrhage in the form of dots on the genital mucosa, the presence of blisters, and redness of the skin. The temperature often rises, vomiting and diarrhea appear.

Symptoms and localization of herpes in infants

Manifestations of herpes can be in different places of the newborn’s body. Depending on what type of herpes virus infected the baby, the distribution of manifestations will be different. So, we will tell you the symptoms in each case in order.

Simple herpesvirus type 1. The manifestation of infection on the lips of the newborn, as well as in the nasolabial area. The rashes are filled with liquid and are small in size. The liquid becomes cloudy over time, and the so-called blisters burst. In place of the burst blisters, wounds appear, which disappear after a while.

The second type, genital. Localization area: genitals, anus. The rashes are small and filled with liquid. The affected area itches and burns. There is also discomfort when emptying the bladder. Lymph nodes enlarge.

The third type is called chickenpox. The rash covers the entire body. They are present not only on the skin, but also on the mucous membranes. This herpes in infants is characterized by an increase in body temperature, the child looks lethargic and weak.

Herpesvirus type 4. If the form is uncomplicated, then there are no symptoms. With the development of infectious mononucleosis, the tonsils and palate are affected. The virus can infect the spleen and liver, and the composition of the blood changes. Symptoms: general malaise, apathy, weakness. In addition, the child has a stuffy nose, a sore and red throat. Lymph nodes become larger in size. The rashes are pinpointed, they look like tiny hemorrhages or pink blisters on swollen skin.

Fifth type. In most cases there are no symptoms. However, there are also characteristic manifestations of this type of herpes in a child. With cytomegalovirus mononucleosis, intoxication of the body begins. This is expressed in a sharp rise in temperature to 39 degrees, a sore throat, and the nasopharyngeal mucosa is red. In difficult cases, infants have pain when swallowing. The child has difficulty breathing, hearing partially or completely disappears. Sometimes internal organs are damaged.

Virus type six. Increased temperature, changes in lymph nodes. The rash is papular-spotty, pink in color. This herpesvirus can cause immunodeficiency in children.

How is genital herpes transmitted to children?

Ways of infection with genital herpes:

1. Intrauterine. This option is possible if there is a high concentration of viral units in the mother’s body. This route of infection can cause abortion.
2. Ascending infection. It represents the movement of the virus from the mother’s genitals to the amniotic fluid and directly to the fetus. What is possible in the presence of placental abruption or its defect.
3. Antenatal. After the child passes through the maternal birth canal, the viral particles are localized in the child’s body. By touching the mucous membrane of the birth canal, the child comes into contact with the virus. For infection, a sluggish or latent form of the disease is sufficient.
4. Infection through contact with the site of the rash. This is the most common option for children from 5 months to three years. At this age, susceptibility to herpes is very high, and those around you try to kiss the baby.
5. Infection through household means through bed linen, through the mother's hands and hygiene items affected by herpetic rash.
6. Sexual intercourse is the cause of genital herpes in adolescence.

Types of herpes in infants

For babies in the first year of life, herpes comes in different types. The forms in which the herpes virus manifests itself are as follows:

• generalized;
• neurological herpes in newborns;
• localized.

In the first case, the generalized form of herpes in infants has the following clinical picture. The virus affected the internal organs and led to intoxication. The baby has difficulty breathing, he may vomit and belch, and the fever can sometimes be very strong.

With the neurological form of herpes, the virus spreads its influence to the nervous system and brain. If the infection occurred in utero, the child may have the following deviations from normal development: microcephaly, hydrocephalus, and the formation of calcifications. Symptoms here vary and are not always typical. The newborn baby appears lethargic or cries incessantly. In addition, the baby may experience a swollen fontanelle and convulsions. Localized herpes in infants. The virus appears in limited places on the child's body. These are the eyes, nasolabial area, etc.

In addition, herpes can be primary or secondary. Primary herpes in newborns can be a consequence of infection of the baby's mother during pregnancy. In addition to transmission of the virus through the placenta, the infection can be transmitted to the fetus during childbirth, when the baby passes through the birth canal. The method of entry of the herpes virus can also be domestic. A baby can become infected with the disease through the belongings of other children or through airborne droplets, as well as from parents.

How does secondary herpes develop? When an infection has entered the body of a newborn, it may not immediately manifest itself. The virus is suppressed by antibodies that the baby's mother transmits to him along with milk during breastfeeding. If the baby’s immune defense decreases, the herpes virus will be activated. In this case, the infection will spread throughout the body, approaching the skin and mucous membranes; visual manifestations of herpes will be visible as a specific rash.

The worst thing is if herpes in infants occurs on the genitals. In this case, the virus can infect the bladder and ureter. Also, such herpes, and it is called genital, can affect important internal organs, including the heart.

What does genital herpes look like in children?

External symptomatic signs of herpes in a child cannot go unnoticed.

They are expressed:

• small collections of blood;
• enlarged lymph nodes in the groin;
• redness in the affected area;
• blisters on the genitals.

There are several forms of the disease.

As the disease progresses to a severe form, the symptoms intensify and the following are added:

• the virus causes pain when urinating;
• belching milk can turn into vomiting;
• the temperature rises;
• loose stools;
• painful paroxysmal contractions of the child’s muscles.

Photo

Rash is not uncommon in children. Here you will find a photo of a rash on a child’s neck with explanations.

Symptoms

The main sign of genital herpes is the appearance on the skin and mucous membranes of the external genitalia of small bubbles (vesicles) filled with a clear liquid. After a few days, these vesicles open, and in their place erosions of an indeterminate shape form. Soon the wounds dry out and turn into thin crusts, which fall off after some time.

Other symptoms include:

• Itching, pain and burning in places where the rash is localized;
• Swelling;
• Hyperemia;
• Pain in the bladder and abdominal area;
• Frequent urge to difficult and painful urination;
• Inflammation of the inguinal lymph nodes;
• Weakness and deterioration of general condition.

Signs of genital herpes appear approximately on the 7th day of infection and are the same for both women and men. The only difference is in the location of the rash.

For men:

• Scrotum and skin of the penis;
• glans penis;
• Groin;
• Foreskin;
• Buttocks and folds under them;
• Skin around the anus;
• External opening of the urethra.

Among women:

• Labia;
• Clitoris;
• Entrance to the vagina;
• Pubis;
• Buttocks;
• Crotch;
• External opening of the urethra;
• Anal area;
• Inner thighs.

Treatment of genital herpes in children

Treatment of infection must be carried out taking into account data on the severity of the disease. The most effective is local and internal use of antiviral drugs, for example, Zovirax (acyclovir) . Course duration is up to 10 days.

For the treatment of older children (from 12 years old), acyclovir, valacyclovir, ribavirin, and famciclovir are used. But it is necessary to take into account that the listed drugs have only a virusostatic effect.

The same antiviral drugs are used to treat lichen. Here you can find detailed information about the symptoms and treatment of shingles in adults.

Local treatment

Genital herpes is treated with local remedies. They bring relief by reducing the intensity of symptoms.

Local exposure is the use of appropriate ointments, creams and sprays that relieve irritation, promoting tissue regeneration. Anti-virus ointments are applied by lightly rubbing into the skin. Carrying out the procedure about 6 times a day.

In this case, it is necessary to follow certain application rules:

• wash the affected area with warm water and soap;
• lubricate the bubbles with a cotton swab, after putting gloves on your hands;
• Wash your hands well after handling.

You might be interested! What is herpes zoster in children and is it contagious?

But medication alone will not get rid of herpetic disease. The main goal is to restore the protective properties of the immune system. Any therapy without the implementation of this direction is ineffective.

Systemic drugs

In the fight against herpes, antiviral drugs are used, as well as interferons and immunostimulants. It is necessary to begin treating the infection when the first signs are detected. Antiviral drugs relieve pain and burning.

Acyclovir is a medicine that is given as intravenous injections or tablets. The method of its administration is chosen depending on the form of viral manifestation and the severity of the disease. Acyclovir is administered intravenously at a dosage of 30-60 mg/kg body weight. Taking the medication should be divided into 3-4 parts.

The drug is also used externally. They lubricate the affected areas 5 times a day. Interferon is used to destroy viruses and prevent their uncontrolled reproduction .

Traditional methods

There are many home remedies for treating genital herpes. In this case, you can get good results. It is important to start fighting the infection when it first appears.

Folk remedies include:

1. Fir oil, which is used to treat affected areas of the skin. The procedure is repeated every three hours. A slight burning sensation is felt during treatment. On the 3rd day of treatment, positive dynamics are observed.
2. Honey with celandine . Grind 50 grams of herbs in a meat grinder and mix with honey in the same amount. The resulting mixture is used to treat the affected areas.
3. Herbal infusion of lemon balm, chamomile, raspberry leaves, juniper fruits, thyme, motherwort. All herbs should be taken in three spoons. Add St. John's wort, wormwood and adonis (1 tablespoon). To stir thoroughly. For infusion, you will need to mix 2 tablespoons of the mixture with two glasses of boiled water and leave for 1 hour. Then strain and take half a glass four times a day for two weeks.
4. Kalanchoe juice is used as a medicine . They moisten a cotton swab and apply it to the rash.
5. You can use a bag of black tea , pour boiling water over it and infuse it. Tea is applied to the affected areas.
6. Healing baths are effective for treatment. To do this, add antiseptic essential oils, such as: tea tree, geranium, lemon, eucalyptus (7 drops each). The bath takes fifteen minutes. Water should be consistent with body temperature.

Herpesvirus infection is currently one of the leading medical and social problems not only in Russia, but throughout the world. The variety of clinical manifestations, characteristics of pathogens, almost 100% infection of the population with certain types of herpes, as well as the possibility of spreading the herpes virus through almost all known routes of transmission allowed the WHO Regional Office for Europe to classify herpesvirus infection as a group of diseases that determine the future of infectious pathology.

Herpesvirus infections, or herpetic infections, include infectious diseases caused by a group of human herpes viruses, which are characterized by a variety of clinical forms and tend to be chronic. Predisposing factors for the development of these diseases are often immunodeficiency states [1, 2].

Herpesvirus diseases are an opportunistic infection that develops against the background of immunodeficiency, and their long, recurrent and severe course is regarded by many dermatologists as para-oncological dermatosis or as an AIDS-marker disease [1, 3, 4].

However, difficulties in solving this problem are associated not only with the peculiarities of the course of herpetic infections themselves, but also with the lack of continuity in providing care to patients. Thus, herpetic lesions of the skin and mucous membrane of the oral cavity are treated by dermatologists and dentists, diseases in childhood are observed by infectious disease specialists and pediatricians, genital herpes is dealt with by urologists, gynecologists and venereologists, ophthalmoherpes - by ophthalmologists, damage to the nervous system - by neurologists, damage to the lymphatic system - by hematologists, oncologists, immunologists.

Herpetic infection is one of the very first viral infections that a small child encounters. Unfortunately, it is not possible to prevent children from becoming infected with viruses at such a high level of infection in the population. A large share in the structure of infectious diseases is accounted for by herpes simplex virus (HSV) infection, the clinical manifestations of which in childhood can have significant differences and an unequal prognosis. In most cases, diseases caused by HSV are characterized only by damage to the skin and mucous membranes (dermatological syndrome) and are mild. However, we should not forget that the course and prognosis of herpes infection in children can be different and depend primarily on the state of antiviral immunity. The presence of passive immunity protects most children under 6 months of age from HSV infection and explains the rarity of herpetic diseases in newborns and infants [3].

In childhood, primary infection with HSV is observed, which can manifest not only with skin rashes and damage to the mucous membranes of the oral cavity, genitals, eyes, but also with a pronounced intoxication syndrome, involvement of the central nervous system (CNS) and other organs. The most severe types of HSV infection are combined forms that develop against the background of immunological and/or allergic disorders. In immunodeficiency states (primary or secondary origin), the development of generalized forms of herpetic infection with the risk of death is possible.

Epidemiology of herpes simplex virus

HSV is ubiquitous, highly pathogenic, and causes a wide variety of clinical conditions. There are two types of viruses: herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). About 80% of initial contacts with HSV (onset of the disease) are asymptomatic. Lesions accompanied by clinical manifestations may differ in severity and variety of symptoms, as well as a high frequency of recurrence. In immunocompromised people, the infection can cause life-threatening conditions [3].

Given the high contagiousness of HSV, infection with the type 1 virus in the vast majority of people occurs in early childhood, after the infant’s passive immunity disappears—maternal antibodies to various infectious agents transmitted transplacentally are destroyed [4]. Most often, children become infected as a result of contact with the saliva of sick parents containing the virus (Fig. 1).

Rice. 1. Residual appearance of labial herpes in the mother and primary infection (Kaposi's eczema) in the child.

A surge in the incidence of HSV-2 is observed in adolescence and adulthood, and detection of this virus in children can be interpreted as an indirect sign of sexual abuse.

HSV can be transmitted directly through close contact with a sick person, as well as sexually and transplacentally. Less commonly observed are airborne, transplantation (during organ transplantation) and transfusion routes of transmission. The incubation period ranges from 3 to 6 days. HSV infection occurs when the virus is inoculated onto the surface of a susceptible mucous membrane (eg, oropharynx, cervix, conjunctiva) or through small skin lesions [4, 5].

The incidence of HSV increases with age and correlates with socioeconomic status, race, and culture. By age 30, 50% of people with high socioeconomic status and 80% with low socioeconomic status are seropositive [6]. A national health survey conducted in the United States [6] revealed HSV-2 seropositivity in 45% of African Americans, 20% of Mexican Americans, and 17% of fair-skinned individuals. It was also noted that seropositivity for HSV-2 is more common in women (25%) than in men (17%). When studying the effect of HSV of various types on the human body, it was noted that antibodies to HSV-1 in patients alleviate the course of the disease caused by HSV-2, and the primary orolabial localization of HSV-1 manifestations protects against genital infection with HSV-1, but not HSV-1. 2 [6, 7].

Clinical manifestations of herpes virus infection in children

Acute herpetic gingivostomatitis

is the most typical manifestation of primary HSV-1 infection, which occurs in children aged 6 months to 5 years. The onset of the disease is acute, the clinical picture is characterized by a violation of the general condition of the child: fever (38-39 ° C), regional lymphadenopathy, anorexia and lethargy. Considering the short incubation period characteristic of HSV, upon examination one can note the presence of signs of the disease in the baby, and residual manifestations of herpes simplex in the parents (hemorrhagic crusts on the lips, wings of the nose, etc.) [8].

Herpetic gingivitis is characterized by swollen, hyperemic, sharply painful “fragile” gums. The vesicles are localized on the mucous membrane of the mouth, tongue and lips, later they quickly open and merge, forming painful erosions covered with a whitish coating. A characteristic sign of herpetic gingivostomatitis is the spread of vesicular-erosive rashes to the mucous membrane of the red border of the lips (Fig. 2).

Rice. 2. Herpetic gingivostomatitis.

The duration of acute herpetic gingivostomatitis is 5-7 days. Virus shedding from saliva can last up to 3 weeks or more. Often, parents “miss” the debut of a herpetic infection, explaining the symptoms of dysphagia and the child’s poor health with teething.

Acute herpetic pharyngotonsillitis

(or herpangina) also refers to frequent clinical manifestations of primary HSV infection. Vesicular elements form erosion-aphthae on the tonsils and posterior wall of the pharynx, covered with a white coating. In school-age children, herpetic pharyngitis and tonsillitis are more common than gingivostomatitis. Characteristic is a combined lesion of the oropharynx and the red border of the lips. You feel unwell: fever, weakness, sore throat. Differential diagnosis is carried out with chronic aphthous stomatitis and damage to the oral mucosa with viral pemphigus caused by Coxsackie enterovirus.

Labial herpes

- the most typical manifestation of a recurrent HSV-1 infection, rashes can be localized not only on the lips, but also on the chin, wings of the nose, periorbital, periauricular, etc. Often manifestations of HSV-1 infection are observed on the skin of the fingers and palms ( especially when saliva gets on injured hands, for example when a child sucks fingers) (Fig. 3) [9].

Rice.
3. Herpetic rashes on the hands of a child. With relapses of herpetic infection in “favorite” places, patients note prodromal sensations of pain, burning and tingling, which are stereotypically felt at the site of further formation of typical herpetic eruptions. The typical form of herpes simplex is characterized by the dynamic development of the elements of the rash: hyperemic papules quickly turn into small thin-walled intraepidermal vesicles, leaving behind erosions. With a long course of the disease (2-3 weeks), the formation of superficial cicatricial atrophy is possible as a result of the disease. A pathognomonic sign of the evolution of herpetic elements is the formation of hemorrhagic crusts, often massive and confluent (Fig. 4).

Rice. 4. Massive hemorrhagic crusts are residual manifestations of labial herpes.

Less commonly, atypical forms of herpes simplex are observed in adolescents. Hemorrhagic-necrotic form

characterized by a large number of grouped vesicles on an edematous hyperemic background.
Some of the vesicles have hemorrhagic contents. When these elements resolve, necrosis and scar formation are observed. Regression of rashes is quite rapid (14-16 days). The edematous form
of herpes simplex often develops in areas of the skin with loose subcutaneous fat (lips, periorbital area, vulva, foreskin).
This form of herpes simplex can lead to the development of persistent swelling, and frequent relapses can lead to the development of elephantiasis-like herpes
.
An impetigo-like form
has been described , reminiscent of streptococcal impetigo in its clinical picture, while rashes in the form of conflicts tend to grow peripherally, and after opening they form massive layered crusts.

Genital herpes

develops in adolescents and young adults soon after the onset of sexual activity. Clinical manifestations of primary genital herpes are more severe in young women. The inflammatory process is characterized by ulcerative or necrotic lesions. Herpetic vesicles are localized on the skin of the external genitalia: labia majora and minora, vestibule and vaginal walls. On the mucous membranes, the blisters quickly open, leaving behind painful ulcers. The vaginal mucosa is inflamed and swollen. The cervix is ​​involved in the inflammatory process in 70-90% of cases. HSV-1 causes urethritis much more often than HSV-2 (Fig. 5, 6).

Rice. 5. Anogenital localization of herpetic rashes in a girl.

Rice.
6. Herpes simplex rash on the buttocks of a boy. In young men, herpetic blisters are localized on the skin of the glans and shaft of the penis, foreskin, and sometimes on the scrotum, inner thighs and buttocks [7].

A rare but extremely severe manifestation of the disease is primary herpes of newborns.

Infection occurs through direct contact of the child with herpetic rashes on the mother during the passage of the birth canal. The risk of infection of a child from a mother with a primary herpes infection is 50% [10, 11]. Primary herpes of newborns is a classic systemic viral disease, often fatal. An unfavorable prognosis is associated with HSV damage to vital internal organs (central nervous system, lungs, etc.). Primary herpes in newborns is characterized by multiple dense vesicular-hemorrhagic rashes on the child's skin; often the mucous membrane of the oral cavity and the conjunctiva of the eyes are involved in the inflammatory process.

An extremely severe form of generalized herpes is herpetic eczema,
or Kaposi's eczema
. The peak incidence in young children occurs between the ages of 8 months and 1.5 years [12]. In children, there is a sharp rise in temperature to 39-40 ° C, a violation of the general condition, and lymphadenopathy. The development of meningeal symptoms, as well as the phenomenon of generalized herpetic infection with the involvement of internal organs in the pathological process, is possible. With recurrent herpetic eczema, in contrast to the primary form, general health is slightly impaired. Rashes in the recurrent form of Kaposi's eczema are localized mainly in places of greatest damage to the skin (for example, the location of herpetic elements in atopic dermatitis on the extensor surfaces of the extremities) (Fig. 7, 8, 9, 10). Often herpetic rashes spread to the periorbital area (Fig. 11). A serious complication in this case is ophthalmoherpes (herpetic conjunctivitis, keratitis, uveitis, chorioretinitis, acute retinal necrosis), which can result in loss of vision [13, 14].

Rice. 7. Severe Kaposi's eczema in an 11-month-old child.

Rice. 8. Vesicular rashes in Kaposi's eczema with umbilical depression.

Rice. 9. Kaposi's eczema.

Rice. 10. Kaposi's eczema.

Rice.
11. Kaposi's eczema. Studies conducted in patients with herpetic eczema that developed against the background of atopic dermatitis confirmed that the greatest risk of this complication is observed in patients with an impaired IFN-γ response [15], with a high level of IgE in the blood serum and polyvalent sensitization [16] . A poor prognostic sign for the development of Kaposi's eczema is also a low level of the antimicrobial peptide cathelicidin peptide LL-37 in the blood [17].

Herpes-associated erythema multiforme exudative (HAMEE) -

a type of infectious-allergic form of exudative erythema multiforme caused by HSV. Erythema multiforme exudative (EME) of herpetic etiology usually develops in adolescents and adult patients, but is not typical for young children [18].

In 95% of patients, GAMEE is combined with orofacial (labial or nasal) localization of herpetic eruptions. The clinical picture of MEE of herpetic etiology is characterized by the appearance of a widespread polymorphic rash on the skin of the trunk and extremities on the 4-6th day from the onset of relapse of herpes simplex. In contrast to the toxic-allergic form of MEE, typical maculopapular target-shaped rashes are characterized by less pronounced exudation, solitary location, stagnant color of the rashes, and relatively small sizes - up to 4 cm in diameter (Fig. 12, 13).

Rice. 12. Residual manifestations on the lips of labial herpes in a teenager with GAMEE.

Rice. 13. Target-shaped maculopapular rash in an adolescent with GAMEE.

The duration of the disease is usually 12-20 days. In some patients, this form may recur several times a year [19].

Researchers have noted that prognostic criteria that increase the risk of developing HAMEE are the presence of the following changes in the immune status of patients with herpes simplex:

- an increase in the spontaneous production of IL-4 and IL-6 in combination with inhibition of their induced production (spontaneous/induced ratio - 1:1);

— in the humoral link there is an imbalance in the synthesis of immunoglobulins with a predominance of IgE and a decrease in IgA with an increase in the absolute content of B-lymphocytes;

- decrease in IFN-α and IFN-γ;

— no increase in NK [20, 21].

One of the hypotheses that explains the occurrence of MEE only in a small number of patients suffering from recurrent herpes is the assumption that the development of HAMEE requires hematogenous spread of HSV - viremia. Recent studies have noted that patients with HAMEE have HSV circulation in affected CD3+, CD4+ cells [22].

Another significant component of the pathogenesis of MEE of herpetic etiology is the development of autoimmune changes in the body: hypersensitivity with an immune complex component of varying severity [23].

Therapy for children suffering from HSV infection

Basic therapeutic measures should be aimed primarily at eliminating the impact of the etiological factor. Causal therapy for herpes simplex is a generally accepted approach to the treatment of acute manifestations of a viral infection and the prevention of its exacerbations and is included in all international standards and recommendations [24, 25]. The main direction of therapy is the use of highly specific antiviral drugs - acyclic nucleosides, which in their chemical structure are modified analogues of the viral DNA component. The first drug was acyclovir. To increase biological activity in the body, acyclovir undergoes three stages of phosphorylation. Acyclovir has specific inhibitory activity against viruses: Herpes simplex

Types 1 and 2,
Varicella zoster
, Epstein-Barr, cytomegalovirus and human herpes virus type 6.

The mechanism of action of acyclovir is associated with inhibition of viral DNA synthesis immediately after phosphorylation of the drug and conversion to the active form - acyclovir triphosphate. The first stage of phosphorylation takes place with the participation of virus-specific enzymes (viral thymidine kinase, which is present in cells affected by the virus). Acyclic nucleosides are most effective when warning signs and/or first symptoms of herpes infection appear. Long-term use of these drugs during the period between relapses serves preventive purposes.

In children, acyclovir is approved for use from birth. Doses of acyclovir are calculated based on 20 mg per 1 kg of body weight in 4-5 doses per day, both parenterally and in tablet form.

The modern second generation acyclic nucleoside is valacyclovir.

(L-valine ester of acyclovir).
Valacyclovir
has a higher bioavailability (54%) and half-life (10-20 hours) compared to acyclovir.
Its effectiveness, high safety profile and ease of use have been repeatedly proven in numerous studies [26, 27]. Valaciclovir
is approved for use
in children over 12 years of age
. Prescription of the drug in adolescents is especially recommended in cases of treatment and prevention of recurrent herpes simplex of various localizations, with herpetic eczema, as well as in complex therapy of GAMEE.

In adolescents, the drug valacyclovir

is prescribed at a dose of 500 mg 2 times a day for a long time (for 7-10 days). The results of treatment of a patient with Kaposi's eczema are presented in Fig. 14 and 15.

Rice. 14. Patient K., 13 years old. Kaposi's eczema that developed against the background of atopic dermatitis - before treatment.

Rice.
15. The same patient. After therapy with valacyclovir 500 mg 2 times a day for 6 days. GAMEE therapy begins with the combined use of steroid hormones and antiviral drugs [28]. All patients are prescribed infusion therapy. Glucocorticosteroids (GCS) are administered parenterally at a dose of 3-5 mg per 1 kg of body weight per day (calculated using prednisolone). The course of therapy with GCS at the indicated dose is 2-4 days, followed by withdrawal within 2-3 days. Valaciclovir

prescribed at a dose of 500 mg 2 times a day for 7-10 days. Long-term prophylactic administration of valacyclovir is recommended for patients who have undergone MEE due to recurrent herpes infection.

Recurrences of genital herpes in children

Recurrence of genital herpes begins with the appearance of precursor symptoms, expressed by burning, pain, swelling in the genital area. Later, a rash appears on the mucous membranes and skin. The vesicles contain a clear liquid that begins to become cloudy. The blisters burst, forming ulcers. After 7-9 days, the ulcers heal spontaneously, leaving no marks.

Provoking factors for relapse are:

• direct contact with a carrier of the herpes virus;
• poor genital hygiene;
• decreased immunity;
• stress.

Treatment

If herpes is detected in a child, the following treatment is prescribed. These are antiviral drugs (tablets and ointments), immunostimulants, and interferons are also prescribed. The method of use - tablets, ointments or even injections - is determined exclusively by the attending physician. The dosage is prescribed individually for each little patient. Self-medication in this case is extremely dangerous and can lead to tragic consequences. You must strictly follow all doctor's instructions to avoid further complications.

Let's talk in detail about medications that can be prescribed to infants:

• drugs to suppress infection;
• immunomodulators and immunostimulants;
• antipyretics and pain relievers (suppositories, suspensions);
• antihistamines;
• antiseptics;
• antibacterial agents if microbial infections have joined the virus;
• To heal and dry wounds and ulcers on the body, brilliant green and sulfur-based ointments are prescribed.

Also, if a child has symptoms such as convulsions due to herpes, then anticonvulsant medications are prescribed. To relieve itching on a child's skin, decoctions of medicinal herbs are used. This is chamomile, calendula. You can also use rosehip oil, etc. Such products will not only remove discomfort on the skin where there is a rash, but will also help the wounds heal faster and relieve inflammation.

The baby needs to drink plenty of fluids. If a mother feeds her baby with breast milk, then she needs a balanced and proper diet. You should consume foods rich in vitamins and microelements. As auxiliary measures, isolation of the newborn from contact with strangers and maintaining the personal hygiene of mother and baby at a high level are used. Care must also be taken to ensure that the baby does not scratch the affected areas. To do this, use clothes that cover the baby's fingers. It is sold in special stores for newborns. They also use so-called scratch pads, hand pads, etc.

Prevention

Measures to prevent genital herpes:

• In a pregnant woman, the manifestation of herpes is dangerous for the fetus. In the antenatal clinic, prevention begins, carrying out constant monitoring in order to promptly identify the primary symptoms of the disease in the mother.
• After the birth of a child, the most effective prevention is long-term breastfeeding.
• If a woman develops herpes on her lips, she should not kiss the baby. Be sure to wash your hands well and often.
• If you have had the infection in the past, the best prevention is to maintain a healthy lifestyle. It is important to avoid overheating and hypothermia. The child should spend enough time in the fresh air, eat properly, and take vitamin therapy in the spring and fall.

When to see a doctor

With a primary infection, the child almost always develops a fever. The baby has no appetite, anxiety, crying, and sleep disturbances. If one of the above symptoms is present or if there are several of them, you need to immediately show the newborn to a specialist - a pediatrician (children's doctor) or a dermatovenerologist.

If the infection develops, it can lead to complications, including death. The herpes virus in newborns should be identified as quickly as possible so that treatment can begin without delay. If there are signs of herpes in an infant, you can visit JSC “Medicine” (academician Roitberg’s clinic) in the center of Moscow. The Pediatrics Department has a staff of highly qualified specialists, new generation equipment and instruments for examination. You can make an appointment with a pediatrician or dermatovenerologist on the website or by calling +7(495)993-00-33.

When should you take your child to the doctor?

Treatment of genital herpes cannot be carried out independently. At the first symptoms, you should immediately consult a doctor. He will prescribe therapy depending on the course of the disease and its location.

To make a diagnosis, clinical manifestations are most often sufficient, but in apathetic and asymptomatic forms it is difficult to identify the cause of the disease, so laboratory diagnostics will be needed. The exact criterion for diagnosing an infection is the direct detection of signs of the virus in the blood or other biological fluids.