Main content
Course: NCLEX-RN > Unit 20
Lesson 1: Sexually transmitted diseases- What are sexually transmitted infections?
- What is gonorrhea?
- Pathophysiology, diagnosis, treatment, and prevention of gonorrhea
- What is chlamydia?
- Pathophysiology of chlamydia
- Diagnosis, treatment, and prevention of chlamydia
- What is syphilis?
- What is tertiary syphilis?
- What is congenital syphilis?
- Diagnosis, treatment, and prevention of syphilis
- What is chancroid?
- What is trichomoniasis?
- What is herpes?
- Pathophysiology of herpes
- What is neonatal herpes?
- Diagnosis, treatment, and prevention of herpes
- What are warts?
- What is bacterial vaginosis?
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What is herpes?
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Want to join the conversation?
- Can't herpes be spread through kissing too? Also, are all coldsores caused by herpes? Because I have had coldsores when I was younger and had never kissed anybody.(5 votes)
- HSV-1 is usually spread through kissing, but any contact with a sore can initiate spread; HSV-2 is almost never spread through kissing. It is generally accepted in medicine that cold sores are caused by herpes. So even though you've never kissed anyone, it may be possible that you picked up the virus from some other type of contact with a sore that you were not aware of. It's also possible that you had something that was similar to a cold sore, but was really something different (like a canker sore). Hope this helps.(2 votes)
- Hello. I thought that herpes simplex being transmitted through blood was a myth?
https://www.herpes.org.nz/patient-info/myths-vs-facts/
It would be great to get some clarification.(2 votes) - can you get herpes after drinking off someone who has vaginal herps?(1 vote)
- NO! but you can get herpes from having oral sex with somebody who has vaginal herpes.(1 vote)
- Why are these so visually descriptive...(0 votes)
- So that you can understand really well. Studies show that if you can see and hear at the same time your brain can develop and understand everything. That is why is is so visual:)(1 vote)
Video transcript
- [Voiceover] A cold sore on
your lips or on your genitals is referred to herpes, I
think you might've heard that term before, and
it's caused by a virus referred to as the herpes simplex virus. The herpes simplex virus or
HSV comes in two flavors. There's HSV1, and there's HSV2. It used to be believed that
HSV1 mainly caused oral lesions, so I'll write up here oral,
and HSV2 mainly caused genital sores or genital lesions. But more recently, it's been
noted that HSV2 can cause oral sores, and HSV1 can
cause genital sores as well. And in fact, this type
of infection is so common that 90% of Americans are
exposed to this by 50 years old. So they're exposed in a variety of ways, which makes herpes simplex virus a sexually transmitted
disease, so if we talk about the modes of
transmission or how it spreads from one infected person
to an uninfected person, that can include sex,
which can be oral sex, vaginal sex, or even anal sex. Childbirth is an important
mode of transmission as well. If an infected mother has any active sores while she's giving birth,
her baby can get exposed to the herpes virus. Or even outside of childbirth,
any contact with open sores can cause transmission of the virus. Or if you were to come into
contact with the bodily fluid that's infected with HSV in another way, so if you were to share bodily fluids, like a healthcare worker
that gets stabbed by a needle that was used to draw blood
from a patient that has HSV, that counts as a mode
of transmission as well. And we'll talk more
about that in a second. Generally, from the first
point of infection right here, so I'll write infection, and we'll make this type of timeline right here. It takes about four to seven days before the first sores appear. And once they're there,
it takes about 10 days for them to heal up and go away. There are six main symptoms
that I'll mention here, and we'll start off here, where you might recognize
this is somebody's lips right here, and they've developed
a cold sore right there. The technical term for this,
because it's caused by herpes, we call it herpes labialis. So for shorthand, I'll
denote this triangle to represent the HSV virus. Why don't we take a closer look
at this cold sore over here? What you might see are
these epithelial cells. So this is an epithelial cell
that exists on your lips, and maybe I should also mention
labia is a term for lips, so herpes labialis is herpes of the lips even though herpes labialis
can occur on your gums, on the insides of your cheeks, or even on the tip of the tongue. So this is a cell of your lips right here. It's this epithelial cell that
has this nucleus right here. What can happen is that
the herpes simplex virus can approach the cell and get inside. As we'll talk more in detail
about it in a separate video, it can start to reproduce
itself by directing proteins away from what the cell
would usually be using these proteins to fortify
its cell membrane, or to grow and survive. So if these proteins are
going in the direction of making more of the HSV virus, over time, the cell will die out. Or another thing that could happen, is that white blood cells that are flowing through your bloodstream
will discover that something is going awry over here,
and start to battle the herpes simplex virus
if they can find it, or they'll target the
cell that's been hijacked, and initiate a process
referred to as apoptosis, which is just the coordinated
killing of a specific cell. Doing so will produce a dead cell, and when several of these
cells on the lips die, that's what gives us the
appearance of a cold sore. A similar thing can happen
down here on the genitals, but when it happens there, we refer to it as herpes genitalis, which is termed this way
because this is herpes in the genitals, and you
can see cold sores happening on the tip of the penis
or even along the shaft, or in women, these may
occur also on the vulva, the vaginal wall, so I'll
just write vagina for now, or even as high up as the cervix. And when these occur,
they usher in symptoms such as pain where the lesion is. They may also burn because
as I'll mention later, once herpes affects the epithelial cells on the tip of the penis
or the vulva, vagina, or even on the skin of the shaft, it'll find its way to a
nerve, and try and go dormant in the cell body of a nerve, which can cause a burning as
well as an itching sensation. One of the things I mentioned here in our modes of transmission for HSV was sharing bodily fluids, and one of the fears that
healthcare workers have is that when they're handling fluids that may be from a patient
infected by herpes, they could get stuck by a needle. So this is my attempt
at a needle right here, and this is the plunger,
you could push to inject or withdraw a fluid. So let's say that we've
drawn up some blood that may be from a patient that has HSV, and if a healthcare worker
accidentally will get pricked right there while
handling this needle poorly, perhaps, then they can get
lesions similar to what we saw earlier with herpes
genitalis or herpes labialis, but occurring on the finger. And these can occur at
the sight of inoculation or the sight of the needle stick, or even regionally close by. And this phenomenon is
referred to as herpetic, referring to herpes, herpetic whitlow. All whitlow means is
an abscess that occurs near the fingernail or the toenail. Imagine a person with herpetic whitlow or somebody that's been
scratching an open sore, accidentally touches their eye, you can spread the herpes
simplex virus here, which can cause what's referred
to as herpes of the eye. And over time, the herpes
infection can cause a type of lesion that
occurs over the cornea, and the cornea is the center
of the eye right here. Again, this occurs if you have
contact with an open sore, and then you touch your eye. So the mode of transmission here can be from your finger to your eye. Another unusual phenomenon that can occur is that if you have a herpes
lesion on your lip right here, this virus, and I'll draw
the virus right there, wants to go and hang
out and become dormant in the cell body of a nearby neuron. In the face, that means it
wants to go and hang out in the cell body of this nerve right here. This guy is called the trigeminal nerve. And this nerve allows you
to feel sensation or touch on your face, so what happens
is that the herpes infection will go and hang out in the cell body of the trigeminal nerve right here until the patient becomes stressed, and then it goes back
down in this direction to cause a sore on your lips. One of the unusual things that can happen and realize the trigeminal
nerve attaches up to the brain, is that instead of going
back down to the lip, the virus could prefer
to go up to the brain. And it can cause what's referred
to as herpes encephalitis, which is an infection of the brain. And that can cause a variety of things like headache, mental
disorders, depression, and even be fatal if left untreated. But this phenomenon is fairly rare, and tends to happen in
patients that have a very poor immune system, which is
why this happens so rarely even though so many
people have been infected with this virus before.