What is herpes?
Herpes is a viral infection caused by the herpes simplex virus (HSV). HSV has two types [1].
HSV type 1 typically causes cold sores, while type 2 most commonly affects the genitals. However, it is possible for both HSV types to infect the mouth and the genitals [2, 3].
Infections by HSV are common. According to the WHO, herpes infected more than half of the world population younger than 50 years in 2016.
However, the general number is probably even higher, as more than 90% of adults in their 50s have antibodies against HSV [4]. Having antibodies indicates that the organism was in contact with the virus.
The virus transmission is via direct contact with an infected individual [4].
Symptoms of herpes
The symptoms of herpes vary from person to person. In some cases, the virus can lead to no symptoms at all. In other people, it will lead to dermatological and other presentations.
The symptoms usually begin within two weeks after infection. They can start with itching around the infected area [5].
Common symptoms of herpes are small, painful sores. It can also present with white blisters filled with clear fluid. They can occur inside or around the mouth and around the genital or anus [6].
Do not touch the blisters. A rupture of a blister can lead to the formation of a painful ulcer [7].
Other symptoms that can accompany the sores or blisters are:
In the case of neonates, older, and immunocompromised people, herpes can cause severe symptoms.
In this group, herpes can lead to encephalitis, sacral autonomic nervous system dysfunction, aseptic meningitis, hepatic failure, and herpes keratitis [8, 4, 9].
Diagnosis and treatment of herpes
Diagnosing herpes starts with the recognition of clinical symptoms. The confirmation of an infection can be done with a laboratory test. Among the tests that can be used to identify the HSV are hybridization on Tzanck smears and immunohistochemistry [10].
To determine whether the organism was in contact with HSV before an antibody serological test can be used [11]. However, this test cannot confirm the present infection.
For treatment of herpes, antiviral drugs like acyclovir, valacyclovir, and famciclovir can be used [10, 12].
What is strep throat?
Strep throat is a bacterial infection. The causative agent of strep throat is Streptococcus pyogenes [13].
The bacteria proliferate in the throat and the tonsils, leading to inflammation and pain in the throat.
The infection spreads via droplets airborne when sneezing, coughing, and sometimes talking [13], making strep throat a highly contagious infection.
Strep throat affects people of all ages. However, it is most common in children from 5 to 15 years [13].
Symptoms of strep throat
Strep throat presents with a variety of symptoms. The symptoms of strep throat include:
- a sudden onset of a sore throat,
- pain when swallowing,
- fever,
- tiredness and fatigue,
- red and swollen tonsils, sometimes with white plaques or spots of pus,
- red dots on the hard palate,
- swollen neck lymph nodes [14, 15].
In the course of the disease, especially children experience nausea and vomiting [14, 16].
People with strep throat can also develop a rash. This rash is called scarlet fever. It consists of small red dots [14].
The appearance of scarlet fever is an immune reaction to the toxins released by the bacteria. Although it does not look dangerous, it needs prompt treatment with antibiotics [14].
Scarlet fever, left without treatment, potentially leads to complications such as kidney damage or rheumatic fever [14].
Diagnosis and treatment of strep throat
The diagnosis of strep throat is based on the symptoms. In unclear cases, the doctor can use a rapid strep A test. It is done with a throat swab and provides results within 15 minutes [17, 18, 19].
However, these rapid tests have drawbacks, because they can lead to false-negative results. Sometimes, when the test is negative, a standard throat culture is taken to confirm the result [20].
A lab test takes 1-2 days, but it is the definitive diagnosis for strep throat [17].
The treatment for strep throat is antibiotics. They stop the growth and proliferation of the bacteria [13].
The most common antibiotics prescribed for strep throat are penicillin and amoxicillin. In cases of allergy to penicillin, substitutions exist, like azithromycin, clarithromycin, or clindamycin [13].
To ease the symptoms of strep throat, over-the-counter painkillers, and throat lozenges are a great solution [13].
At home, to help with the infection, drinking a lot of liquids and rest is needed [13].