Superadded bacterial and fungal infections in oral and genital herpes simplex lesions

Background: Two types of herpes simplex virus (HSV) HSV type 1 (HSV-1) and HSV type 2 (HSV-2) can cause oral and genital infections, respectively. Superadded bacterial and fungal infections of HSV lesions are one of the complications seen in herpes simplex infections. Objective: The study aims to identify the super added bacterial and fungal infections in oral and genital herpes simplex infections. Materials and Methods: This is an observational study carried out at SRM Medical College Hospital and Research Centre, Tamil Nadu, India, from February 2019 to February 2020 after the Institutional Ethical committee approval. Patients with clinically suspected oral and genital herpes infections in all age groups are included in the study excluding neonates and infants. Under aseptic precautions vesicular fluid, blood and wound swabs were collected. Vesicular fluid examined by Tzanck smear for multinucleated giant cells, and Immunoglobulin M enzyme-linked immunosorbent assay performed in positive cases. Superadded bacterial and fungal infections identified using conventional culture and identification methods. Results: In this observational study, a total of 75 patients were screened for oral and genital herpes infection. Thirty-five (46.6%) were clinically positive. Out of the positive cases, Tzanck smear was positive in 17 (48.6%), superadded bacterial and fungal infections are seen in 18 (51.4%). The most common super added infections are Candida albicans 9 (50%), Candida non-albicans 4 (22.2%), Escherichia coli 2 (11%), Staphylococcus 1 (5.6%), Enterococcus 1 (5.6%), and Proteus mirabilis 1 (5.6%). Conclusion: Most common superadded infections associated with oral and genital herpes simplex infections are with Candida species, E. coli, and Staphylococcus.