Herpes Simplex Virus Infection

Herpes simplex virus (HSV) infects epithelial and mucosal cells. Viral replication damages those cells, producing inflammation and the characteristic vesicles, pain, and ulceration. HSV-1 and HSV-2 can both cause oral or genital infection; the location of a lesion does not reliably identify the viral type. After the initial infection, HSV travels along sensory nerves and remains latent in a sensory ganglion. It can reactivate later and travel back to the skin or mucosa. Fever, ultraviolet exposure, stress, hormonal changes, and immunosuppression can promote reactivation, although some episodes occur without an obvious trigger. This latent phase explains why antiviral treatment controls an episode but does not eradicate the infection. HSV is not primarily a wound-healing disorder. Routine pressure-injury measurements, ankle-brachial index testing, or nutritional wound investigations do not explain a new cluster of painful vesicles. The practical nurse instead focuses on lesion pattern, pain, hydration, urinary function, neurological and ocular symptoms, immune status, and the possibility of transmission.