Herpes gladiatorum B00.1

Herpes gladiatorum is a cutaneous infection caused by HSV (herpes simplex virus)-1 through skin-to-skin contact during martial arts, usually wrestling.

The localization of the skin lesions differs significantly from the usual orolabial localization of HSV-1 infections. The head is usually affected, 30% -40% of the trunk and the extremities. Herpetic conjunctivitis or blepharitis is less common.

Dermatological symptoms: Disseminated roundish or striped reddish or red-yellow lesions consisting of vesicles (usually no longer detectable), erosions, pustules and crusts (pyoderma-like).

Constitutional symptoms are common and include fever (in 25 %), chills (in 27 %), sore throat (in 40 %) and headache (in 22 %) (Belongia EA et al. 1991). Sensitive regional lymphadenopathy is detectable in most patients.

Outbreaks of herpes gladiatorum have been observed in wrestling training camps. Prophylaxis with valaciclovir is recommended in the USA for wrestlers in larger training camps. A previous orofacial infection with herpes simplex virus type 1 does not reliably protect against newly acquired herpes gladiatorum.

In the case of herpes gladiatorum, the question of occupational disease must be examined in accordance with BK 3102 (BK no. 3102). This number covers those infections and their clinical pictures that are usually transmitted from animals to humans. Certainly a special case is the transmission from humans to humans, which is referred to as "direct (ortho-) zoonosis". In this case, the infection occurs through direct contact or through a mechanical vector from one vertebrate to another (e.g. scabies transmission from human to human).

1. Belongia EA et al (1991) An outbreak of herpes gladiatorum at a high-school wrestling camp. N Engl J Med 325:906-910
2. Centers for Disease Control (CDC) (1990). Herpes gladiatorum at a high school wrestling camp--Minnesota. MMWR Morb Mortal Wkly Rep 39:69-71.
3. Dyke LM et al. (1965) Skin infections in wrestlers due to herpes simplex virus. JAMA 194:1001-1002
4. Mirfazaelian H et al (2013) Herpes gladiatorum. Emerg Med J 30:89
5. White WB et al (1984) Transmission of herpes simplex virus type 1 infection in rugby players. JAMA 252:533-535