Genital herpes

Primary or secondary infection due to herpes simplex virus II (in 80-90% of cases) or HSV I (10-20%).

• Vulvovaginitis herpetica
• Cervicitis herpetica
• Proctitis herpetica
• Urethritis herpetica
• Balanitis or balanoposthitis herpetica

Transmission through skin to skin contact, mostly sexual intercourse / oral sex.

Genital redness and swelling with (often grouped localised) herpetiform vesicles, erosions and haemorrhagic crusts, sometimes painful, often severe itching; reduced AZ, fever, restlessness, vomiting.

• Clinical manifestion (exclude meningismus)
• If needed:
  • PCR or microtrack
  • Biopsy is rarely helpful

• Possible "peripartum" infection of the newborn in women
• Secondary infection with bacteria or candida

• Healing after 3-4 weeks
• Recurrences occur mainly in the first year after initial infection, with males showing symptoms more frequently

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2. Corey, L., et al., A Trial of Topical Acyclovir in Genital Herpes Simplex Virus Infections. New England Journal of Medicine, 1982. 306(22): p. 1313-1319.
3. Corey, L., et al., Once-Daily Valacyclovir to Reduce the Risk of Transmission of Genital Herpes. New England Journal of Medicine, 2004. 350(1): p. 11-20.
4. Fiddian, A.P., et al., Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy. Journal of Antimicrobial Chemotherapy, 1983. 12(suppl B): p. 67-77.
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14. Spruance, Spotswood L., et al., Application of a Topical Immune Response Modifier, Resiquimod Gel, to Modify the Recurrence Rate of Recurrent Genital Herpes: A Pilot Study. The Journal of Infectious Diseases, 2001. 184(2): p. 196-200.
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