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Product

Genital Herpes
Item#:  SB51


Price:  $299.00


Item description



For use with your IMULUX Treatment light, the IMULUX Genital Herpes Med Pak is a single treatment solution that can be purchased separately for additional family members and friends that also need treatment. Order along with your IMULUX Treatment Kit and save on shipping costs. Order today! Please note: the IMULUX treatment does not suggest that it is safe to have unprotected sex. It is always recommended to protect yourself and others against STDs of all kinds.
Genital Med Kit: $299.00
Includes three "med paks" and one treatment lamp.

Refills: "Med paks" without lamp for treatment of a friend or partner only: $249.00

GENITAL HERPES

Overview

Genital Herpes (Herpes Simplex-II) attacks the area on and around sex organs, causing blisters and sores. It is highly contagious and very aggressive, causing frequent outbreaks.

Genital Herpes symptoms can vary in severity and may well be severe for 2 to 10 days. However for some patients, blisters or open, weeping lesions can last weeks or months. In addition, genital herpes patients can suffer from significant emotional distress because of the intimate nature of the infected area and its social consequences.

Transmission of Genital Herpes

Genital Herpes is spread easily. It is most commonly contracted by contact with an infected person during sexual intercourse. The virus enters the body through a crack or cut in the skin or through the skin around the mouth, penis or vagina, urinary tract opening, cervix or anus.

Genital Herpes is most contagious when blisters or sores can be seen on the infected person. However, it can be spread at any time, even when there aren't visible symptoms.

Genital Herpes can also be spread from the original site to other parts of the body, such as from the genital area to the hands or feet. The eyes can also be infected. Genital herpes can also be spread from a mother to her baby during birth.

Stages of Genital Herpes

Once infected, an individual will go through different stages of infection.

Primary stage The initial stage begins up to 8 days after infection, however the virus may remain dormant in the body for a longer period of time. The typical initial outbreak results in groups of small, painful blisters. The blister fluid can be clear or cloudy. The skin in the area will become red and inflamed. The blisters are easily ruptured and become open sores. The transition from blister to sore can occur so rapidly the blister stage may not even be noticed.

Besides having tender blisters or sores in the genital area, the patient may experience pain when urinating. A fever and other flu-like symptoms may also be experienced.

The majority of individuals infected experience a painful primary stage of infection. It is also possible not to experience any symptoms at all. These individuals are not aware they are even infected.

Latent stage After the initial outbreak, the genital herpes virus will go into a latent stage, where the individual will experience no blisters, sores or other symptoms. During the dormant or latent cycle, the genital herpes virus travels to the nerve ganglia in the spinal region.

Shedding stage The virus multiplies in number in the nerve ganglia. The virus can also migrate to body fluids, such as saliva, semen or vaginal fluids. The process is called shedding. Although no symptoms are evident during the shedding stage, the virus can still be transmitted to other areas of the body or another individual.

Recurrences Most people experience additional outbreaks although, in most cases, the symptoms are not as severe.

Stress, being sick or being tired may result in a recurrence. Exposure to the sun or the menstrual period may also cause a recurrence. Typically a recurrence gives advanced warning by the individual feeling an itching, tingling or pain in the area of the initial outbreak.

What should I do if I think I have herpes? The sooner treatment is administered, the less pain will be experienced.

Treatment

Prior to the advent of PHOTHERAPY, there was no medical option that could both stop an outbreak of genital herpes and prevent subsequent outbreaks.

There is no prescription medicine that will cure Genital Herpes. Some medicines can help. For example, acyclovir (brand name: Zovirax) can speed up healing and lessen the pain of Herpes for some people. It can treat primary or recurrent herpes and may lessen the number of recurrences.

Famciclovir (brand name: Famvir) and valacyclovir (brand name: Valtrex) are other medicines used to treat recurrent Genital Herpes.

Shedding Light on the Solution for Genital Herpes… PHOTOTHERAPY

PHOTOTHERAPY is not a prescription medicine; no pills to swallow, no side effects to endure. It is a remarkably effective treatment that utilized a unique combination of light energy and an activating solution.

With PHOTOTHERAPY you can physically see the treatment progress as it isolates and kills the Genital Herpes virus.

When the Genital Herpes blisters are opened, the PHOTOTHERAPY solution applied, and the areas exposed to the IMULUX light, the Genital Herpes virus will react within a few seconds to the light bombardment.

The infected area will actually begin to fluoresce (glow brightly). You may feel a tingling sensation and, at the same time, pain will begin to subside. The exposed area provides a passageway for the Genital Herpes virus itself to be attacked by PHOTOTHERAPY.

In less than 30 minutes the treatment will be complete and your Genital Herpes virus killed. The PHOTOTHERAPY treatment will enhance most patients’ ability to fight future symptoms: another outbreak will never occur.

Note: If the infected area does not fluoresce, the condition is other than Genital Herpes, which may not be successfully treatable by PHOTOTHERAPY. If so, simply return the product for a prompt and full refund with in 30 days of purchase.




My name is Dr. Jon Stoneburner and in 1970 I made a discovery that would help change the life of thousands of people suffering from Herpes and Papilloma viruses (genital warts). This discovery was granted a US patent in 2001 after years of scientific research and testing.

Current research tells us that the herpes virus lives and hides deep in the nervous system and soft tissues of the body during the “inactive stage” where it is almost impossible to find and destroy. This is a fact that no researcher will deny.

The virus must enter a host (such as a blood cell or nerve ganglion) in order to replicate (multiply and infect) or the “active stage”. This is a fact that no researcher will deny.

The herpes virus does not survive well in the presence of hyper oxygenation or the presence of ultraviolet light. This is a fact that no researcher will deny.

Rather than try to find a way to get to the viruses that were hiding I found a way to trap the virus during the replication stage (active outbreak) as if it were in jail. Science has found a way to deliver an “atomic bomb” (ultraviolet light and oxygen) to the home of the virus while in this active stage which causes the virus to expand 300 times its normal size in milliseconds, like an atomic explosion, instantly causing the virus to disintegrate into microscopic pieces that the body can use to form antibodies.

The protocol I will tell you about is the first of its kind and has helped thousands live an outbreak free life.

It is my sincere wish that you can use this and get a second chance at life again.
Sincerely yours,
Dr. Jon F. Stoneburne


PHOTOTHERAPY: A Product of Energy Medicine

Background: Chemical-based medicine falls short

The need for a new approach to infectious and other life-threatening diseases arose from the failure of conventional medicine to provide effective solutions.

For the past 100 years or longer, conventional practitioners have depended on a chemical resolution for treatment of foreign pathogens of the body, such as the herpes virus.

From the earliest days of antibiotics -- when it was discovered that bread mold helped to heal infected lesions, leading to the discovery of penicillin -- we have embraced chemical treatment as the utilitarian goal of medicine.

We have added various tools for diagnosing various pathogens, and even found enhanced antibiotics through scientific research and development.

For the herpes virus, an array of expensive pharmaceuticals on today's market can perhaps shorten the duration of an outbreak. But these medications are unfortunately unable to conquer this particularly insidious pathogen.

Energy medicine offers solutions

The concept of energy medicine, once a dream of the medical community, became reality in the last 30 years. It is based on developing techniques that help the body's own natural defense mechanisms maintain good health.

Energy medicine has gained significant traction throughout the medical community; it has been utilized with great success for many years.

For example, ultra-sound instruments aid in the healing process of many diseases. In addition, devices using electrical stimulation can diagnose and alleviate pain from a range of discomforting and deforming conditions.

Finding a solution for herpes

It is only natural that energy medicine is now being deployed in empowering the body's cells to repel the invasion of pathogens, such as the herpes virus.

This has been accomplished by dedicated scientists, who have turned to energy medicine to pioneer the first truly breakthrough solution for the treatment of herpes.

The Process of Illumination

Just as harnessed energy of the sun can be productively used, so can the specially designed ultraviolet (UVA) rays emitted by IMULUX lamps.

This light energy source, in tandem with the PHOTOTHERAPY solution, can effectively suppress further outbreaks from the virus at hand.

Why PHOTOTHERAPY works

Ultraviolet light and herpes viruses do not get along. The herpes virus does not survive well in the presence of ultraviolet light. The PHOTOTHERAPY protocol discovered a way to deliver ultraviolet light beneath the skin, the home of the virus during an active outbreak. This photon lending substance removes the protection of the skin which absorbs and reflects the ultraviolet light in our environment. Once light enters the viral home there are several theories have been proposed to explain how PHOTOTHERAPY achieves its goal. Here at PHOTOTHERAPY we know that it works even if we don’t have the final explanation as to why it works. Most drugs on the market today have an unexplained mechanism of action.

The cells of every living organism - except viruses - have energy powerhouses called mitochondria.

The mitochondria in our cells accept nutrients and convert them to usable energy to maintain life.

Since viruses lack mitochondria, they have no way to process nutrients to sustain their own life. Without a power source to convert nutrients the virus will die.

True parasites, viruses must have a host to survive. So they turn our epithelial cells, hook up to the cells mitochondria and create an infection, essentially using the epithelial cells as a host. As the infection completes its cycle and the virus leaves this host, it then travels to nerve cells, converting them into their host and borrowing their mitochondria to process nutrients.

See the drawing below.

Figure 1. The herpes simplex virus life cycle. (a) Herpes simplex virus (HSV) is shown undergoing the lytic cycle (entry, uncoating, viral transcription and DNA replication in the nucleus, particle assembly, exit from the cell) in epithelial cells of the skin to cause a primary infection. (b) Some virus enters the sensory neuron terminals and travels retrogradely to the nucleus where it establishes latency. (c) Periodic reactivation results in anterograde transport of viral particles, shedding from the neuron, and re-infection of epithelial cells, which leads to asymptomatic shedding or recurrent lesions.

One theory is called the polarity principle;

The Polarity Principle

For a virus to find its host, it has to be attracted to it.

We recall from high-school science class that positive and negative charges attract each other, while charges with the same polarity repel one another.

If we assume that the virus has a negative polarity and the host cell has a positive polarity, they would attract each other.

By training the IMULUX light on the accompanying treatment solution, pure photon energy bombards the infected cells, which changes the virus' polarity from negative to positive.
With this polarity change, the herpes virus is repelled, loses its hosts, cannot find other hosts in which to reside, and dies.

This action effectively eliminates any herpes outbreak on the spot.
Even better, the virus dies in one infected cell after another throughout the body. As this occurs, the dead viruses cause the body to form antibodies -- protecting you from future outbreaks.
The effectiveness of this treatment process has been validated by scores of patients for whom PHOTOTHERAPY has proven to be the solution after years of herpes suffering.

Another theory involves Ace Pigments (alternative cellular energy)
Ace pigments theory;

We all remember a process in plants called photosynthesis. The Ace pigment theory proposes that there is an alternative energy source for epithelial cells in the human body that collects light and converts it to energy; thus making the host cell more vital or giving the host cell enough renewed metabolic energy to allow it to eject the parasitic virus. It is a known fact that the virus seems to attack stressed cells and is less likely to be found in cells with a good metabolic activity. In effect the PHOTOTHERAPY protocol gives the host cell the ability to fight off its invaders.

With this renewed energy the lesion site is better able to heal itself and the outbreak is cancelled. The virus unable to find a new host simply dies.

A third theory has to do with physical destruction of the virus itself.

It has been observed in the laboratory that the virus actually absorbs the photon lending solution and when exposed to the ultraviolet light the solution expands its molecular structure several hundred times in a millisecond. This physical change in the molecule of the solution blows the virus up into pieces to which the body can make an army of antibodies. This kills the virus instantly stopping pain and spread of the lesion on the spot. The lesion dries up and begins healing immediately. Since the virus is dead it cannot escape and hide in the nerve ganglion.

PHOTOTHERAPY works effectively on any of the eight human herpes types provided there is a skin outbreak. This includes oral, genital and shingles (herpes zoster). PHOTOTHERAPY also works effectively on Condyloma (a general class of viruses known to be responsible for genital warts). It has even been found in clinical studies to be an effective treatment for common non-genital warts.

Success is achieved by applying the PHOTOTHERAPYsolution to the affected area in the first 24 to 96 hours of an outbreak. The solution is absorbed by the cell wall of the virus. When exposed to the IMULUX treatment light, the solution transfers pure photon energy to the infected cells, which effectively eliminates any herpes outbreak within 24 hours.

What is PHOTO-THERAPY FOR HERPES?

  • PHOTO-THERAPY FOR HERPES is a groundbreaking herpes treatment consisting of a safe, non-prescription solution developed by IMULUX LTD and a specially designed ultraviolet (UVA) lamp.

How is PHOTO-THERAPY FOR HERPES applied?

  • PHOTO-THERAPY FOR HERPES is very simple to use. The application of PHOTO-THERAPY FOR HERPES is a simple, two-part process. First, the photon lending topical solution is applied to the cleansed outbreak area. Then, the special ultraviolet (UVA) light treats the area for about 10 minutes (up to 30 minutes for the most severe cases). The affected area usually tingles and a temporary color change of the solution occurs. Once the area changes from yellow to red and the tingling stops, the treatment is complete.

How does PHOTO-THERAPY FOR HERPES work?

  • A PHOTO-THERAPY FOR HERPES treatment stops outbreak pain immediately and helps to heal viral infections. Even better, PHOTO-THERAPY FOR HERPES actually helps to teach your body to eliminate the virus internally, and helps stop future outbreaks.
    Medical science has known for decades that the herpes virus cannot live in the presence of ultraviolet light (UVA) but have found it all but impossible to deliver UVA light directly to the herpes virus which hides in the blood cells, nerve ganglia cells, and soft tissues of the body beneath the skin. The skin of the human body not only reflects UVA light but also absorbs almost all of it. The cell wall of the virus also reflects and absorbs UVA light, thus it is almost impossible to deliver light to the cytoplasm of the herpes virus. The IMULUX solution (a harmless photon lending solution) safely penetrates the human skin and the cell wall of the virus allowing UVA photons of light to pass through the skin and cell wall of the virus unaltered. The virus is now exposed to pure UVA photons of light immediately killing the virus.

Does PHOTO-THERAPY work on all viruses?

  • PHOTO-THERAPY FOR HERPES works effectively on many of the HHV (human herpes viruses), provided there is a skin outbreak. This includes oral, genital and shingles (herpes zoster). PHOTO-THERAPY also works effectively on HPV; Papilloma (a general class of viruses known to be responsible for genital warts). It has even been found in clinical studies to be an effective treatment for common non-genital warts.  Success in the treatment of Psoriasis and even Actinic Keratosis has been demonstrated. Success is achieved by applying the photon lending solution to the affected area in the first 24 to 96 hours of an outbreak. The solution is absorbed by the cell wall of the virus. When exposed to the PHOTO-THERAPY FOR HERPES treatment light, the solution transfers pure photon energy to the infected cells, which effectively eliminates any outbreak.  The virus is literally blown into pieces with this protocol. This, in turn, stimulates your bodies natural process of producing antibodies, much like an immunization.

How effective is PHOTO-THERAPY FOR HERPES?

  • PHOTO-THERAPY FOR HERPES, in research and development since 1974, has been used to treat thousands of people successfully. In fact 93% of all treatments have proven effective in stopping outbreaks on first application. The success rate rises to 99% on the second treatment. In rare cases three or more applications are required.

What if my physician has never heard of PHOTO-THERAPY FOR HERPES?

  • Since PHOTO-THERAPY FOR HERPES has just recently been introduced to the world market, it is likely that your physician has not yet heard of PHOTO-THERAPY FOR HERPES In this case, please refer your physician to our website or have them contact Dr. Stoneburner at jstoneburner1@juno.com for further information.

Can I use PHOTO-THERAPY FOR HERPES on delicate areas such as my eyes?

  • For PHOTO-THERAPY FOR HERPES to be used on places such as the eyes the treatment should be supervised and guided by a health care professional only. Please consult your doctor before attempting to treat yourself in this case.

Can I use PHOTO-THERAPY FOR HERPES if I have no visible symptoms?

  • No.

Can I use the PHOTO-THERAPY FOR HERPES treatment if I am pregnant?

  • PHOTO-THERAPY FOR HERPES is not recommended for women during pregnancy, even though it has not been found to have any side effects. As with anything while you are pregnant or nursing, please consult your physician.

Can I use IMULUX if I have AIDS or some other immune deficiency?

  • PHOTO-THERAPY FOR HERPES scientists have found no side effects from using the PHOTO-THERAPY FOR HERPES treatment on patients with a compromised immune system; however we would recommend that you consult your physician.

Are the products sent discreetly?

  • All orders are sent in a plain unmarked carton with a return address from Dr. Jon Stoneburner.

What name will show up on my credit card?

  • There will be no mention of herpes anywhere on your statement. Dr. Jon Stoneburner will appear on your credit card statement.

How long does PHOTO-THERAPY FOR HERPES last?

  • All available data indicates that there is no time limitation to the effectiveness of PHOTO-THERAPY FOR HERPES. The vast majority of patients report that since treatment, their outbreaks have never returned.

What are the side effects of PHOTO-THERAPY FOR HERPES?

  • PHOTO-THERAPY FOR HERPES has been tested thoroughly and found to be completely safe. Although the IMULUX solution may stain the treated area for a few days, it is harmless. Early clinical trials reported that fewer than 3 individuals per 10,000 applications experienced an allergic reaction to the activated solution at the lesion site, which were easily resolved with a mild topical steroid cream. A skin sensitivity test can be done prior to use on patients especially sensitive to skin allergies, PHOTO-THERAPY FOR HERPES is not recommended for women during pregnancy, even though it has not been found to have any side effects.

How quickly will I see results?

  • Results are immediate. Pain should subside at the end of the treatment. Scabbing of lesions also begins at the end of the treatment. Healing of lesions is noticeable within 24-48 hours.

How can it work if it isn’t a drug?

  • In its attempt to control the herpes virus, medical science treats the body with various chemicals, only to find that the virus can mutate and become more virulent -- or that the medicine does more harm to the body than it does to the virus. PHOTO-THERAPY FOR HERPES is the first medical treatment without dangerous side effects with the ability to kill herpes viruses no matter how resistant they are to prescription drugs.

Do I need to continue using your product forever?

  • No. The beauty of the PHOTO-THERAPY FOR HERPES difference is that 93% of all treatments have proven effective in stopping outbreaks on first application. The success rate rises to 99% on the second treatment. In rare cases three or more applications are required.

Does PHOTO-THERAPY FOR HERPES come with a guarantee?

  • Yes. At PHOTO-THERAPY FOR HERPES customer service and confidence in PHOTO-THERAPY FOR HERPES are extremely important to us. We back this guarantee with a full money back guarantee.

Can I save money and purchase only the med packs and use a different light?

  • No. For your PHOTO-THERAPY FOR HERPES treatment to be effective you must you use both the PHOTO-THERAPY FOR HERPES treatment light combined with the photon lending med packs. The PHOTO-THERAPY FOR HERPES guarantee is invalid utilizing any other light source as your treatment is likely to fail.

What about other alternative medicine procedures I find on the Web? Will they work?

  • We have investigated many of them, only to find they do not meet the promises they advertise. Because PHOTO-THERAPY FOR HERPES goes beyond suppression and does not require the continuous application or consumption of medications with serious side effects, it is in a class by itself compared with other products.

How does PHOTO-THERAPY FOR HERPES compare to anti-virals like Valtrex, Famvir or Acyclovir?

  • Clinical investigators find the benefits of PHOTO-THERAPY FOR HERPES treatment to exceed any benefits received from conventional accepted medical protocol and treatment regimes. Current anti-viral therapies cannot make claims of complete safety and effectiveness because they do have side effects, some serious, and suppression of symptoms can take several days. Investigators of PHOTO-THERAPY FOR HERPES consistently report immediate (within 24 hours) results from PHOTO-THERAPY FOR HERPES.

What exactly is the herpes virus?

  • For more information about herpes viruses, please visit the Understanding Herpes section on the pull down tab of the Home page.

I’m not sure I have Herpes.

  • It is important to be professionally diagnosed by a health care professional. If you do not have the herpes virus active in your body, this treatment will not work to eliminate your symptoms. Please contact your physician prior to purchasing the PHOTO-THERAPY FOR HERPES treatment.

I have just conducted my phototherapy treatment and my lesions did not fluoresce. What should I do?

  • There are several reasons this may occur. Please contact customer support immediately for guidance.

What should I do if I have another outbreak?

  • There are many classifications of the herpes virus and numerous sub-types. It is possible for a patient to harbor multiple strains of the virus or be re-infected with another strain of the herpes virus. Should this occur please see our wellness program as part of The PHOTO-THERAPY guarantee.

TOP OF THE PAGE

PHOTOTHERAPY for Genital Herpes Treatment Directions

Read through all instructions carefully before beginning treatment

TO BE EFFECTIVE THE TREATMENT MUST BE ADMINISTERED NO SOONER THEN 24 HOURS AFTER AN OUTBREAK AND NO LATER THEN 96 HOURS .

Your IMULUX for Genital Herpes Treatment Kit Includes:

  1. The IMULUX treatment fixture and lamp.
  2. Three PHOTOTHERAPY Genital Herpes Powder containers, and  three Activating Solution bottles.
Procedure:
STEP #1

Clean and Scrub lesion. This should be done for 30 minutes, by soaking in a hot bath just prior to administering the procedure.

STEP #2

Puncture and open the scabs or blisters in the area to be treated. This can be accomplished by one of the following methods:

  1. Scrub the blisters until they are open or even oozing.
  2. Use a sterilized needle to prick open the blisters.

Important: For successful treatment the PHOTOTHERAPY solution must be allowed to enter the open scabs or blisters. Take great care in making sure the scabs or blisters are properly opened.

STEP #3

Tap the Genital Powder container softly several times on a flat surface to knock the contents to the bottom then carefully unscrew the top.

STEP #4

Unscrew the top of the Activating Solution bottle and carefully pour into the Powder container approximately ½ of the solution.

Stir the mixture with the cotton swab until the solution turns bright red. The red solution is now ready to apply directly with the cotton swab to the cleaned and scrubbed lesion site. Note the solution only has an effective life of about two hours so do not mix the solution until you are ready to do the treatment.

STEP #5

Paint the open lesion site, using the cotton swab, with the red solution. There should be no pain or burning associated with applying the solution to the lesion site. There might be a mild tingling sensation, which is normal.

STEP #6

Plug IMULUX treatment lamp contained in your treatment kit into a 120V outlet. If your outlet current is different then 120V you must use a voltage adaptor set to change your electric output to match the fixture’s 120V requirement. The fixture would be destroyed if the adaptor set is not used for voltage other then 120V.

STEP #7

Darken room for light treatment.

STEP #8

Position yourself so you are comfortable and support the lamp so it is approximately 1 inch above area to be treated. Turn on lamp by pressing the white switch located on the power cord to the “ON” position.

STEP #9

Expose the lesion site to the IMULUX light for a period of not less than 10 minutes and a maximum exposure of 30 minutes. (Note: The IMULUX light is an ultraviolet light source, which has been designed with a precise level of intensity and light frequency which delivers specific photons of light necessary for the IMULUX treatment. When used per these instructions; exposure to the light is harmless to surrounding tissues. Treatment with a light source other than the IMULUX light will be in effective and void the PHOTOTHERAPY guarantee.)

*In the first minute of treatment the lesion site will start to fluoresce. You may experience a mild tingling sensation after one or two minutes and the lesion site may begin to ooze a small discharge of fluid. Under the illumination of the IMULUX light, this discharge will appear yellow to orange at first and then turn a darker yellow or orange. As the virus is destroyed, the color change takes place.

*The tingling sensation may subside after as little as 10 minutes or continue for up to 30 minutes. If the tingling sensation ends in less then 10 minutes continue the treatment for the minimum exposure time of 10 minutes.

*When the discharge has changed to darker yellow or orange, or when the tingling sensation subsides, the procedure is complete.

*Pain and irritation should be gone immediately after the procedure.

STEP #10

Bathe and clean the treatment area with soap and water immediately following completion of treatment.

Attempt to keep the area dry for the next 24 hours.

STEP #10 Two additional treatment “med paks” are enclosed should you need additional treatments as a result of treating too soon or too late. Sometimes individuals will treat a skin rash that is not herpes but rather a “jock itch” or fungal infection. Should you make this mistake additional “med paks” are provided.

HERPES VIRUSES IN MAN

Herpesviruses in Man

The human herpesviruses, including Herpes simplex virus (HSV), Varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), human herpesvirus 7 (HHV-7), and human herpesvirus 8 (HHV-8) may produce a variety of clinically significant manifestations either as self-limited infections or non-resolving opportunistic infections.

Many herpesviruses commonly infect man, but clinically apparent or life-threatening illness are most often seen in persons who are immunocompromised, including persons with primary or secondary immunodeficiencies (including AIDS), persons undergoing cancer chemotherapy, transplant recipients, persons with lymphoreticular malignancies involving the hematologic and/or mononuclear phagocyte system, persons receiving chronic corticosteroid therapy or having increased endogenous corticosteroid production (Cushing's syndrome), and persons who are severely debilitated and/or malnourished.


HERPESVIRUSES, TYPES 1 AND 2
VARICELLA ZOSTER VIRUS

Both HSV types 1 (HSV-1) and 2 (HSV-2) primarily infect skin and mucus membranes (mucocutaneous infections) to produce inflammation, often vesicular, progressing to sharply demarcated ulcerations. Herpes simplex type 1 mainly involves the oral cavity, often as the so-called "cold sores" that many people have experienced. HSV-2 more often involves the genital region as a sexually transmitted disease. However, either body region may be infected by either subtype to produce clinically and histologically indistinguishable disease, which is not surprising, given the 50% homology between the genomes of HSV-1 and -2. The lesions, though small, can be quite painful.

Two distinct clinical manifestations are seen with the Varicella zoster virus (VZV):

  1. Chicken pox as a primary infection (varicella) in children
  2. "Shingles" as reactivation of latent infection (Herpes zoster virus, or HZV) in adults

CLINICAL FEATURES OF HSV AND VZV

All herpesviruses exhibit latency following initial infection. Either HSV or VZV infection initially occurs through mucosal surfaces or through abraded skin via contact with a person who is excreting virus through active, usually ulcerative, lesions. Excretion of HSV-1 can be detected in 2 to 9% of asymptomatic adults, while HSV-2 can be isolated from the genital tract in up to 5% of males and up to 8% of females in sexually transmitted disease clinics.

Viral replication begins within epithelium and underlying dermis or within submucosa. From these initial sites, HSV or VZV spreads to nerve endings and is transported intra-axonally to neurons in ganglia, from which spread is then via peripheral sensory nerves back to other, usually adjacent, skin and mucosal sites.

Thus, vesicular HSV or VZV lesions may later appear or recur away from the initial site of involvement.

After an initial host response in which both cell-mediated and humoral mechanisms take part, the infection usually becomes latent, with HSV or VZV present but not actively replicating within ganglia. It is unclear just how reactivation of HSV, or VZV as HZV, occurs but lack of cell-mediated immunity in immunocompromised patients may be implicated.

Clinical Diagnosis:

Diagnosis of HSV or HZV infections is suggested by the appearance of crops of clear vesicles in groups on mucocutaneous surfaces. Vesicles may resolve completely, but in some cases infection becomes persistent and ulcerations occur, most commonly with HSV infections about the oral cavity or perianal region. The typical patient with HSV or HZV has a grouped vesicular skin eruption that ruptures, crusts, and heals in seven to ten days. Infection may be associated with a history of severe pain, often persisting for months after the skin lesions resolve. Scarring also occurs, and secondary bacterial infection may complicate herpetic lesions.

Ulceration may obscure the features and make diagnosis difficult unless a Tzanck preparation, biopsy, or viral culture is done to establish the diagnosis. Multiple herpetic lesions tend to ulcerate due to persistence for prolonged periods (with or without therapy), excoriation, or secondary infection.

  • Chronic HZV infections may be characterized by pseudocarcinomatous hyperplasia, verrucous epidermal hyperplasia, and massive hyperkeratosis.
  • Reactivation of VSV as HZV with shingles may often occur as an early manifestation of immune compromise.
  • Internal organ involvement with HSV and HZV is infrequent, and disseminated infections are uncommon, but the clinical course can be one of recurrences.
  • Herpetic mucocutaneous lesions of immunocompromised patients, including those with AIDS, have been reported to be more extensive, more severe, and longer-lasting, with more ulceration, necrosis, and pain than in immunocompetent patients.

Microbiologic Diagnosis:

Viral culture remains the most sensitive clinical method for HSV or HZV diagnosis; methods for antigen detection are less sensitive. Culture sensitivity is higher when the herpetic vesicular lesions first appear and before they ulcerate. Later ulcerative lesions may have no detectable virus. Serologic testing is mainly of value for detection of past infection, but not acute infection, for immunocompromised patients are unlikely to mount a significant (fourfold or greater) rise in anti-HSV titer between acute and convalescent samples.

Tissue Diagnosis:

Microscopically, lesions of HSV and HZV both in tissue biopsies or from cytologic preparations (Tzanck or Pap smears) demonstrate characteristic acantholytic epithelial or discohesive parenchymal cells, often multinucleated or in clusters, with mauve to pink to steel-gray ground glass intranuclear (Cowdry type A) inclusions. The cytoplasm of infected cells is not prominent and, unlike CMV, does not contain inclusion bodies of any kind. With ulceration, such cells may be infrequent or autolyzed. Surrounding sqaumous epithelium may show ballooning degeneration.

For HZV, typical cytologic features most often occur in cells between papillae and dermal adnexae. On average, cells infected with HSV or HZV do not reach the size of those with CMV, and the intranuclear inclusions of CMV tend to be darker and larger, and intracytoplasmic inclusions may accompany CMV. Immunoperoxidase staining with primary antibody against HSV-1, HSV-2, and HZV will help to exclude other viral etiologies such as CMV, EBV, and human papillomavirus (HPV).

Organ Involvement:

Encephalitis from HSV is the most common viral infection of the CNS in the U.S., with an estimated incidence of 2.3 cases per million per year. The clinical course and radiologic findings of HSV encephalitis may closely mimic those of progressive multifocal leukoencephalopathy (PML), though computed tomograpahic or magnetic resonance imaging scans showing evidence of hemorrhage, a mass effect, or gray matter involvement more strongly suggest herpes.

Grossly, HSV produces areas of necrosis most commonly in temporal lobe, inferior frontal lobe, insula, or cingulate gyrus. Microscopically, herpetic lesions can have petechiae with fibrinoid necrosis, perivascular mononuclear inflammatory cell infiltrates, and Cowdry type A inclusions in either neurons or glial cells.

Ocular herpes is the most frequent etiology for corneal blindness in the U.S. However, with AIDS deeper infection is more frequent, with the complication of chorioretinitis reported.

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