Herpes B virus: Difference between revisions
| Line 27: | Line 27: | ||
==Management== | ==Management== | ||
*Treatment | *Treatment | ||
**<20 minutes clean and irrigate | **<20 minutes clean and irrigate | ||
*Prophylaxis: | *Prophylaxis: | ||
**14 day course of PO Valacyclovir 1gm three times daily | **14 day course of PO Valacyclovir 1gm three times daily | ||
**14 day course of PO Acyclovir 800mg five times daily | |||
*All non-CNS symptomatic: Admit and treat | *All non-CNS symptomatic: Admit and treat | ||
| Line 47: | Line 41: | ||
*[[Rabies]] Treatment | *[[Rabies]] Treatment | ||
===Asymptomatic Prophylaxis=== | |||
*Treat if high risk for transmission: | |||
**Penetrating (especially head, neck, torso) | |||
**Fluid on mucosa | |||
**Blistering Monkey | |||
==Disposition== | ==Disposition== | ||
Revision as of 02:05, 12 September 2015
Background
- Cercopithecine herpesvirus 1 (commonly referred to as B virus)
- Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters
- Fatal Encephalomyelitis in Humans: 80% fetal without treatment
- Most common transmission by bite, but very few cases
- Consider in Patients with Exposure, especial penetrating bites, to Macaque Monkeys in the wild or research
Clinical Features
- Vesicular Herpetic Lesions
- Nonspecific Flu-like Illness
- Lymphadenitis
- Site of inoculation - pain, numbness, itching
- CNS - poor coordination, respiratory depression
- Encephalitis - late stage of the disease
Differential Diagnosis
Diagnostic Evaluation
- Clinical
- PCR specificity and sensitivity at nearly 100% for serologic
- PCR wound samples less reliable
- All symptomatic should be tested
Management
- Treatment
- <20 minutes clean and irrigate
- Prophylaxis:
- 14 day course of PO Valacyclovir 1gm three times daily
- 14 day course of PO Acyclovir 800mg five times daily
- All non-CNS symptomatic: Admit and treat
- Acyclovir IV 12.5-15 mg/kg every eight hours OR
- Ganciclovir IV 5mg/kg every 12 hours
- All CNS Symptomatic Admit and treat
- ganciclovir IV 5mg/kg every 12 hours
- Rabies Treatment
Asymptomatic Prophylaxis
- Treat if high risk for transmission:
- Penetrating (especially head, neck, torso)
- Fluid on mucosa
- Blistering Monkey
Disposition
- Asymptomatic Discharge
- Symptomatic Admit
See Also
External Links
References
- B Virus (herpes B, monkey B virus, herpesvirus simiae, and herpesvirus B). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/herpesbvirus/ Page last reviewed: July 18, 2014. Accessed April 3, 2015.
- Cohen JI, Davenport DS, Stewart JA, Deitchman S, Hilliard JK, Chapman LE; B Virus Working Group. Recommendations for prevention of and therapy for exposure to B virus (cercopithecine herpesvirus 1). Clin Infect Dis. 2002 Nov 15;35(10):1191-203. Epub 2002 Oct 17.