She was taking simple analgesia - Paracetamol and Ibuprofen as required. On examination there was erythema of the nose extending from the radix and both medial canthus to the alar rims. There was no intranasal involvement on nasal endoscopy. She had a temperature of Broad spectrum intravenous antibiotics were commenced. On Day 1 a dermatology opinion was sought and a provisional diagnosis of herpes simplex made based on the clinical findings. Viral serology and a swab were sent for analysis and culture.
On day 2, since there was no clinical improvement topical Aciclovir was added to the treatment regimen. The patient was instructed to avoid direct sunlight exposure and massage the area with Vaseline or E45 cream to help further improve the cosmetic appearance.
Taken in the outpatient department 2 months after hospital admission showing the patient's healed nasal skin. Herpes simplex virus has two subtypes; HSV1 is more common and generally causes ulceration around the mouth or nose known as cold sores whereas HSV2 is more likely to cause genital lesions.
Via a similar pathological mechanism to varicella zoster, there is the possibility of latent and recurrent disease. Following primary infection the virus lies dormant in dorsal root ganglia of sensory nerve fibres.
In response to a number of possible triggers the immune system is no longer able to contain latent viral replication and the virus is reactivated.
Possible triggers are sunlight, immunosuppression, stress, fever and menstruation. Diagnosis of HSV can be made on clinical presentation, direct fluorescent antibody assay, tissue culture, histopathology with immunohistochemistry, electron microscopy or PCR. Serology alone may give a high number of false positives as there is a high prevalence of HSV antibody in the normal population.
Unusual presentations of HSV usually occur in immunocompromised individuals and in the literature have particularly been described in association with fludarabine chemotherapy and patients with lymphoma [ 1 ]. Rarely necrosis can occur and surgical debridement is necessary [ 2 ].
It is important that we are aware of this unusual nasal presentation of a common viral pathogen and are therefore able to instigate early anti-viral therapy to reduce associated morbidity. Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
HP and JA were the registrar and consultant looking after the patient during their hospital admission. HP took the clinical photographs, gained the patient's consent, and wrote up the manuscript with constant guidance and support from JA. Posted 4 years ago. Sounds like the swab test for hsv2 was for your nose so I'm going to go with that. Supposedly after having HSV for a while past your initial ob, you produce enough antibodies to avoid auto-infection a person already infected infecting another part of their body.
I don't really know but maybe your nose got infected years ago and took this long to OB. Or possibly somehow your immunity got low enough to autoinfect years after initial ob.
I think I read once about a guy who auto infected his eye a few years after his initial ob. They say in early years OBs come x a year and by about 3 yrs, maybe once per yr and barely noticible. While docs say autoinfection is most likely during initial, I think maybe it's still possible enough in first years for it to be measurable risk.
I got oral ob only about 6mos after my initial That or I may have had oral hsv1or2 much of my life and never thought anything of an occasional Oral blister till after I contracted genital HSV. I don't think you had blisters in your nose and didn't notice tho! That's really painful! So far as your husband never having symptoms, either he has never caught it or he has it and is asymptomatic or symptoms are mild enough to not be noticible.
If you or he are curious, he could get a blood test for HSV. I would be curious myself. Please share results if you guys do that. Join this discussion or start a new one? We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately.
Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms. Such a complex prevents the reproduction of the virus and helps to reduce symptoms. Also recommended drugs that stimulate the immune system Immunoriks, Cycloferon, Arbidol , and fortifying agents tincture of ginseng and echinacea. It is useful to drink a course of multivitamin complexes.
With frequent relapses of the disease with a rise in temperature, in addition to these methods, antiviral agents are used in injections or suppositories. During the treatment of the active phase of "colds" in the nose, it should be remembered that at this moment a person poses a danger to other people. Therefore, if possible, do not attend work and other public places.
At the same time, it is recommended that you follow certain rules:. During an exacerbation it is useful to drink herbal tea from chamomile, calendula and St. John's wort to enhance the immune system. Strong antiviral properties are possessed by essential oils of coniferous trees - cedar, pine, fir. However, they must be used with caution - it is a concentrated means, if used improperly, a mucosal burn can be obtained. A primary risk in pregnancy is primary infection with the herpes virus.
In this case, the body has not yet had time to develop antibodies, which leads to such consequences as miscarriage, pathologies in the development of the child, premature birth. If a woman at the time of pregnancy has already had herpes, then even relapses of the disease can not affect the health of the mother and the future baby.
Treatment of rashes in the nose in this period should only be dealt with by a doctor, since many antiherpetic drugs are prohibited during pregnancy. Possible use of local drugs zinc ointment, Zovirax , vitamin complexes and folk methods. During lactation, most drugs are also banned. With the permission of the doctor, local preparations are used in the form of ointments and gel. If the rash in the nose is not very troubling to the child, and the general condition is not violated, then the use of medications will be impractical.
It is believed that the immunity of the child must cope himself. Moreover, most anti-herpetic drugs can not be used for children under 12 years old.
The only exception is Acyclovir. They can be treated with mucous times a day.
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