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Herpes, Genital, Emergency Medicine

Kathleen A. Kerrigan and Jason L. Grimsman Reviewed 06/2017



  • Genital herpes is a lifelong recurrent infection

  • ∼1 in 4 Americans older than age 30 are seropositive for herpes simplex virus type 2 (HSV-2):

    • Most are asymptomatic

  • 1st episode/primary ...


Signs and Symptoms

  • Local pain and itching

  • Herpetic cervicitis, vaginitis, or urethritis may present with dysuria, urinary hesitance or retention, vaginal discharge, or pelvic pain

  • Herpetic phar...



Universal precautions should be maintained 

Initial Stabilization/Therapy

Rarely required unless associated with systemic symptoms requiring hospitalization: 
  • Disseminated infection

  • ...



Admission Criteria

  • Systemic involvement (encephalitis, meningitis), significant dissemination

  • Severe local symptoms (pain, urinary retention)

  • Severely immunocompromised patient

Discharge Criteria

Pearls and Pitfalls

  • Treat primary infections

  • Consider sexual abuse in children with genital herpes

  • Herpes is a lifelong infection

Additional Reading

  • ACOG Committee on Practice Bulletins. ACOG Practice Bulletin No. 82: Management of herpes in pregnancy. Obstet Gynecol.  2007;109:1489–1498.

  • Borhart  J, Birnbaumer  DM. Emergenc...



  • 054.10 Genital herpes, unspecified

  • 054.11 Herpetic vulvovaginitis

  • 054.13 Herpetic infection of penis

  • 054.19 Other genital herpes

  • 054.12 Herpetic ulceration of vulva

  • 054.1 Genital herpes


  • A60.0...

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