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General Medicine

Herpes, Genital

Cecilia M. Kipnis, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Chronic, recurrent herpes simplex virus (HSV) type 1 or 2 infection of any area innervated by the sacral ganglia

  • HSV-1 causes anogenital and orolabial lesions.

  • HSV-2 causes anogenital ...

DIAGNOSIS

HISTORY

  • Many patients are asymptomatic (74% of HSV-1 and 63% of HSV-2) or do not recognize clinical manifestations of disease (2).

  • If symptoms are present during primary episode, they are ofte...

TREATMENT

GENERAL MEASURES

  • Ice packs to perineum, sitz baths, topical anesthetics

  • Analgesics, NSAIDs

MEDICATION

Start antiviral medications within 72 hours of onset of symptoms (including prodrome). After...

ONGOING CARE

GENERAL PREVENTION

  • Use barrier contraception and avoid sexual contact when symptoms/lesions are present.

  • Abstinence is the only means of complete protection.

Patient Monitoring

Test for HIV a...

REFERENCES

1
LeGoff J, Péré H, Bélec L. Diagnosis of genital herpes simplex virus infection in the clinical laboratory. Virol J.  2014;11:83. [View Abstract on OvidMedline]
2
Hofstetter AM, Rosentha...

ADDITIONAL READING

  • Dhankani V, Kutz JN, Schiffer JT. Herpes simplex virus-2 genital tract shedding is not predictable over months or years in infected persons. PLoS Comput Biol.  2014;10(11):e100...

CODES

ICD10

  • A60.00 Herpesviral infection of urogenital system, unspecified

  • A60.04 Herpesviral vulvovaginitis

  • A60.09 Herpesviral infection of other urogenital tract

  • A60.01 Herpesviral infection of penis

  • A60...

CLINICAL PEARLS

  • Genital herpes is caused by HSV-1 and/or HSV-2.

  • Many seropositive individuals are unaware that they are infected.

  • Most primary episodes are asymptomatic.

  • Viral shedding occurs in the abse...

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FIG. 6.2. Eczema herpeticum. Ulcers and excoriations, as in these two cases [patient 1 (A, B), patient 2 (C)], usually characterize the eru...
FIG. 6.2. Eczema herpeticum. Ulcers and excoriations, as in these two cases [patient 1 (A, B), patient 2 (C)], usually characterize the eruption, although vesicles may be seen at times (D). More severe cases [patient 3 (E), patient 4 (F, G), patient 5 (H)], with generalized eruptions, require intravenous therapy with acyclovir.
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