Gladiatorum herpes simplex virus in Adult
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Synopsis
The exact incidence of herpes gladiatorum is not known, but usually it afflicts young and active individuals engaged in contact sports. The disease typically presents with an incubation period of about 3-5 days, followed by the eruption of painful grouped vesicles on an erythematous base. HSVG usually presents on the torso, legs, shoulders, neck, or forearms. In one large outbreak occurring at a high school wrestling training camp, HSVG was identified in 60 of 175 wrestlers, and most lesions were present on the head (73%), the extremities (42%), and the trunk (28%). Autoinoculation may result in infection at multiple sites on the body.
Depending on the intensity of the host response, a primary herpes infection, including HSVG, may be accompanied by systemic manifestations including fever, sore throat, headache, and lymphadenopathy.
Like all other HSV infections, the condition resolves with dormancy in the dorsal ganglia. During future periods of reduced immune function, repeat eruptions will occur in the same anatomic area as the primary infection. Scarring may also result from the eruption, and lesions close to the eyes may lead to herpes keratitis, an ophthalmologic emergency.
Codes
ICD10CM:B00.1 – Herpesviral vesicular dermatitis
SNOMEDCT:
240475000 – Cutaneous herpes simplex infection
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Differential Diagnosis & Pitfalls
- Impetigo – A superficial infection with group A Streptococcus, impetigo results in erosion and intense crusting, but it is usually not as deep-seated, painful, or recurrent as herpes infections.
- Folliculitis – Bacterial or fungal folliculitis is follicularly centered and generally not as acutely painful as herpes. Although folliculitis is recurrent on occasion, the lesions are not confined to the same anatomic location as they are in recurrent herpes episodes.
- Tinea – Tinea corporis produces annular lesions with central clearing that are intensely pruritic rather than painful.
- Cellulitis – Expanding erythema, without a predominance of vesicles, is identified in most cases of cellulitis.
- Zoster (shingles) – Reactivation of varicella-zoster virus (VZV) infections (shingles) cannot be distinguished from HSV by light microscopy alone, but instead requires clinicopathological correlation. Zoster is chiefly a disease of older patients, and it is usually limited to a single dermatome; it is typically not as cyclical as HSV infections.
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Last Reviewed:01/30/2017
Last Updated:01/26/2017
Last Updated:01/26/2017
Patient Information for Gladiatorum herpes simplex virus in Adult
Overview
Herpes simplex virus (HSV) gladiatorum (HSVG), or herpes gladiatorum, is simply an HSV infection arising from nonsexual physical contact, such as wrestling or other sporting activities. The virus is spread when one person comes in physical contact with another person's rash.HSVG infections that occur in healthy individuals resolve by themselves, but they sometimes come back. This is because after the body fights the virus, the virus travels into the nerves and stays in the nerve roots. During future periods of stress and illness, repeated outbreaks will occur in the same area as the first infection. Scarring may also result from the outbreak, and rashes close to the eyes may cause the virus to infect the eye.
Who’s At Risk
Herpes gladiatorum usually affects young athletes engaged in contact sports.Signs & Symptoms
The rash usually shows up on the torso, legs, shoulders, neck, or forearms. Three to five days after an individual has contact with an already infected person, the infected skin becomes red and groups of blisters appear. The skin rash may be accompanied by fever, sore throat, headache, and swollen lymph nodes.Self-Care Guidelines
Be careful not to touch the infected area, as you can spread it to other parts of the body or to other people. An athlete with herpes gladiatorum cannot return to practice or competition until all open blisters are crusted over. Even then, when blisters are no longer active, the athlete may still theoretically shed the virus, although the risk to others is markedly reduced. In general, only the area of skin with the rash is contagious, but it is important not to share towels or clothing while the outbreak is still active.When to Seek Medical Care
If the virus infects the eye, go to the emergency department right away.Treatments
Antiviral therapy shortens the duration of symptoms and may prevent spread, but it does not prevent the virus from hibernating in the nerve root. Your doctor may prescribe antiviral medications such as acyclovir, valacyclovir, and famciclovir for a period of time, usually less than 2 weeks.Antiviral medications shorten the duration of the symptoms and may prevent spread to other parts of the body or to other people. Taking medication will not change the fact that the virus will continue to live in the nerve roots.
Gladiatorum herpes simplex virus in Adult