<p>Infeksi herpes simpleks virus 1 rekuren dengan faktor predisposisi stres emosional</p><p>Recurrent herpes simplex virus 1 infection with predisposing factors of emotional stress</p>

Abstract

ABSTRAKPendahuluan: Infeksi Herpes Simpleks Virus 1 (HSV 1) pada rongga mulut merupakan suatu penyakit yang diawali gejala prodromal yaitu demam diikuti munculnya vesikel pada wajah, mukosa mulut, dan bibir. HSV 1 bersifat laten di dalam tubuh dan dapat rekuren yang dipicu oleh paparan sinar matahari, stres emosional, kondisi imunosupresi, kelainan hormonal dan trauma saraf. Laporan kasus ini bertujuan untuk membahas infeksi HSV 1 rekuren intraoral (RIH) dengan faktor predisposisi stres emosional. Laporan kasus: Seorang perempuan 35 tahun datang ke poli Ilmu Penyakit Mulut didiagnosis RIH sejak 3 bulan sebelumnya dengan keluhan sariawan di lidah dan tenggorokan yang didahului demam. Ekstra oral tidak ditemukan kelainan sedangkan intra oral terdapat ulser, dasar kekuningan, tepi ireguler, dikelilingi eritem di lateral lidah kiri, palatum posterior, orofaring dan gingiva disertai rasa sakit. Hasil pemeriksaan darah anti HSV 1 Ig G reaktif dengan nilai 21,3 pada kunjungan dan 31,4 setelah terjadi kekambuhan. Setelah dilakukan anamnesis yang mendalam,stres emosional diduga sebagai pemicu RIH, dimana musibah yang dialami pasien mengakibatkan stres emosional yang memicu berulangnya RIH. Terapi farmakologis berupa asiklovir sistemik, obat kumur khlorheksidine glukonat, vitamin B 12 serta asam folat, sedangkan pengelolaan stres diberikan sebagai terapi non farmakologi. Infeksi sembuh setelah 3 minggu. Selain terapi farmakologi, pasien ini diberikan motivasi untuk mengelola stres, terbukti pengelolaan stress dapat mempercepat penyembuhan RIH. Simpulan: Infeksi HSV 1 rekuren intraoral (RIH) dengan faktor predisposisi stres emosional dapat sembuh dengan terapi farmakologi berupa pemberian antivirus, obat kumur dan vitamin dan terapi non farmakologi pengelolaan stres dalam bentuk self suggestion menunjukkan perbaikan lesi pada minggu kedua dan sembuh pada minggu ketiga. Kata kunci: Infeksi herpes simpleks virus 1 rekuren, stres emosional, tata laksana Recurrent herpes simplex virus 1 infection with predisposing factors of emotional stressABSTRACT Introduction: Herpes simplex virus 1 (HSV 1) infection in the oral cavity is a disease that begins with a prodromal symptom which was a fever followed by the appearance of vesicles on the face, oral mucosa, and lips. HSV 1 is latent in the human body and can be recurrently triggered by sun exposure, emotional stress, immunosuppression conditions, hormonal abnormalities, and nerve trauma. This case report was aimed to discuss the recurrent intraoral HSV 1 (RIH) infection with predisposing factors of emotional stress. Case report: A 35-years-old woman who came to the Oral Medicine Clinic was diagnosed with RIH for 3 months before with the chief complaint of oral thrush on the tongue and the throat preceded by a fever. No extraoral abnormalities were found, while intraoral examination results found an ulcer, with the yellowish base, irregular edge, surrounded by erythema lateral to the left tongue, posterior palate, oropharynx, and gingiva, and accompanied with the soreness. The result...

Clinical variability of recurrent oral HSV‐1 infection with a high level of serum IgG antibody: Three case reports

“…2,7,13 Immunosuppressive condition is among the factors that can reactivate HSV-1 infection. 1,7 Primary infection and reactivation in immunocompromised patients as happened in our first case (history of kidney disease and hypertension) will involve many cells and have a greater risk of acyclovir resistance than the normal population. 14 All three patients in this report experienced a reactivation of HSV-1 and presented with different clinical features as well as different clinical diagnoses.…”

“…Aside from immunosuppressive conditions, stress is also one of the contributing factors in HSV-1 reactivation, which results in an increase in the concentration of HSV-1 titers and corticosterone (CORT) in plasma and ultimately causes latent conditions. 7,19 Stress hormones will increase along with pituitary hormone axis (HPA) activity and immune system modulation. 7,20 Stress-assisted immunomodulation (SAI) is an immune response to HSV reactivation caused by stress, whereas during acute and chronic stress, the body releases epinephrine, interleukins (IL-1, IL-6), Cyclic Adenosine Monophosphate (cAMP), glucocorticoids, and prostaglandins.…”

“…12 Afterwards, these gene are expressed: immediateearly, early, and late genes, followed by DNA replication, nucleocapsid assembly, capsid maturation, envelope formation, then the new virus will be released (shedding) in the saliva, and dormant in the sensory nerves of the trigeminal ganglion. 2,7,13 Immunosuppressive condition is among the factors that can reactivate HSV-1 infection. 1,7 Primary infection and reactivation in immunocompromised patients as happened in our first case (history of kidney disease and hypertension) will involve many cells and have a greater risk of acyclovir resistance than the normal population.…”

“…6 HSV infection can be latent or reactivate. 2,7 The predisposing factors to cause remission are sunlight, emotional stress, immunosuppression, hormonal dysfunction, or neural trauma. 7 The transmission can be passed through saliva, genital fluids, or organ transplantation.…”

“…2,7 The predisposing factors to cause remission are sunlight, emotional stress, immunosuppression, hormonal dysfunction, or neural trauma. 7 The transmission can be passed through saliva, genital fluids, or organ transplantation. 1,2 Oropharyngeal lesions and recurrent blisters are commonly caused by HSV-1 infection.…”