herpes simplex dendritic ulcer
DESCRIPTION
HERPES SIMPLEX DENDRITIC ULCER. Prepared by: Nutrimala Nadia Nasip Ulfa Nur Izzati Abd . Wahid Deena Khairiah Baharuddin Siti Nur Hazwanti Hamzah Ophthalmology department 4 th year Zagazig University. INTRODUCTION. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/1.jpg)
HERPES SIMPLEX DENDRITIC ULCERPrepared by:
Nutrimala Nadia NasipUlfa Nur Izzati Abd. Wahid
Deena Khairiah BaharuddinSiti Nur Hazwanti Hamzah
Ophthalmology department4th year Zagazig University
![Page 2: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/2.jpg)
INTRODUCTION It is a primary, superficial, infective
ulcer having a dendritic shape caused by Herpes Simplex Virus (epitheliotropic type).
![Page 3: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/3.jpg)
Dendritic ulcer stained with fluorescin
![Page 4: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/4.jpg)
Herpes Simplex virus
![Page 5: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/5.jpg)
PATHOPHYSIOLOGY
Primarily responsible, above waistOrofacial & ocular infection
HSV-1Transmitted sexually
Genital diseases, passed to neonates
HSV-2
![Page 6: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/6.jpg)
![Page 7: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/7.jpg)
Virus becomes dormant in trigeminal (V) ganglion
Inter-neuronal spread1ry HSV-1 infection; in childhood
Direct contact of skin or mucous membrane with virus-laden lesions or
secretions
![Page 8: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/8.jpg)
PREDISPOSING FACTORS
Fever Menstruation
Drugs Psychic stress
Low resistance
![Page 9: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/9.jpg)
Recurrence occurs with decreased body resistance
Virus becomes active
Vesicles in mouth, genitalia, cornea
![Page 10: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/10.jpg)
Close-up view of early herpes outbreak shows small, grouped blisters (vesicles) and lots of inflammation (erythema).
![Page 11: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/11.jpg)
FREQUENCY HSV infection is ubiquitous, with an
estimated one third of the population worldwide suffering from recurrent infections.
![Page 12: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/12.jpg)
CLINICAL ASPECTS OF DENDRITIC ULCER
![Page 13: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/13.jpg)
HISTORY Patients with HSV keratitis may
complain of the following:› Pain› Photophobia› Poor vision› Profuse lacrimation› Blepharospasm
![Page 14: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/14.jpg)
![Page 15: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/15.jpg)
SIGNS
Corneal stromal inflammation
Infectious epithelial keratitis
![Page 16: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/16.jpg)
Endothelitis Blepharo-
conjunctivitis
![Page 17: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/17.jpg)
DIAGNOSISRose bengal
Fluorescin
Mix
![Page 18: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/18.jpg)
Dendritic ulcer stained with fluorescin
![Page 19: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/19.jpg)
Dendritic ulcer stained with Rose Bengal
![Page 20: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/20.jpg)
COMPLICATIONS
Eye infection
Throat infection
Eczema herpeticum
![Page 21: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/21.jpg)
Erythema multiform
Nervous system
Widespread infection
![Page 22: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/22.jpg)
![Page 23: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/23.jpg)
DIFFERENTIAL DIAGNOSIS
Bacterial & fungal keratitis
Peripheral ulcerative keratitis
Superficial punctate keratitis
![Page 24: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/24.jpg)
Acant
hamoeba
ker
atiti
s
Photokeratitis
Int
er
stiti
al
ker
atiti
s
![Page 25: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/25.jpg)
TREATMENT
Local•Antiviral (acyclovir)•Atropine•Local antibiotic•Bandage
General•Vit A & Vit C•Acyclovir tablet
Resistant •Debridement•Cauterization•Therapeutic keratopathy
![Page 26: HERPES SIMPLEX DENDRITIC ULCER](https://reader035.vdocuments.mx/reader035/viewer/2022062218/56816598550346895dd87296/html5/thumbnails/26.jpg)
Thank You