Herpes Genitalis
exp date isn't null, but text field is
Herpes Genitalis is an infection of the genital or anogenital area by herpes simplex virus (herpesvirus hominis type 2). Type 1 (HSV-1) is the most common cause of genital ulceration in developed countries. It is moderately contagious and usually spreads by sexual contact. Lesions usually develop 4 to 7 days after sexual contact. The condition tends to recur because the virus establishes a latent infection of the sacral sensory nerve from which it reactivates and re-infects the skin.
Clinical FeaturesThe primary lesions are more painful, prolonged and widespread than those of recurrent infections. Itching and soreness usually precede a small patch of erythema on the skin or mucous membrane. A small group of painful vesicles develops, they erode and form several superficial, circular ulcers with a red areola, which coalesce.
The ulcers become crusted after a few days and generally heal with scarring in about 10 days. The inguinal lymph nodes are usually slightly enlarged. Tender lesions in men may occur on the prepuce, glans penis, and penile shaft whereas in women may occur on the labia, clitoris, perineum, vagina and cervix. In addition to pain, in primary infection, the patient may experience generalized malaise, fever, difficulty in micturition or difficulties in walking.
DiagnosisThis is mainly clinical but can be confirmed by tissue culture.
Scrape the roof of the blister and make a smear. Stain with Papanicolaou stain. Giant multinucleated cells are diagnostic
Complications
- Aseptic meningitis
- Transverse myelitis
- Autonomic nervous dysfunction involving the sacral region leading to urinary retention.
Drugs
- Acyclovir 200mg orally 5 times daily for 7 days for initial infection.
- Acyclovir 200mg orally 5 times daily for 5 days for recurrent infection.
| Genital Ulcer Disease | Syphilis | Benzathine Penicillin 2.4M.U IM weekly x 3 doses | Benzathine Penicillin 50 000units/ kg IM weekly x 3 doses |
| Chancroid | Ciprofloxacin 500mg PO BD x days | ||
| Herpes Genitals | Acyclovir 400mg TDS x 7 days | Acyclovir 20mg/kg 8 hourly for CNS and disseminated disease; extend therapy to 21 days; for disease limited to the skin and mucous membranes for 14 days | |
| Lymphogranuloma Venerium | Doxycycline 100 BD x 14 days |