Genital Herpes

Question 1

What causes genital herpes?

Answer 1

Herpes simplex virus
HSV-1 and HSV 2

Question 2

What happens after initial infection with herpes?

Answer 2

Virus becomes latent in associated sensory nerve ganglia

Trigeminal nerve ganglion for cold sores

Sacral nerve ganglia with genital herpes

Question 3

What can herpes simplex virus cause?

Answer 3

Aphthous ulcers
Herpes keratitis
Herpetic whitlow (painful lesion on finger or thumb)

Question 4

How is herpes simplex virus spread?

Answer 4

Direct contact with affected mucous membranes

Viral shedding in mucous secretions

Question 5

What are each of the herpes simplex virus strains associated with?

Answer 5

HSV-1
Cold sores
Genital herpes through oral-genital sex

HSV2
Genital herpes, mainly STI

Question 6

How does genital herpes present?

Answer 6

Usually in 2 weeks , initial episode is most severe
- Ulcers of blistering lesions
- Neuropathic type pain
- Flu-like symptoms
- Dysuria
- Inguinal lymphadenopathy

Question 7

How is genital herpes diagnosed?

Answer 7

Clinical diagnosis

Viral PCR

Question 8

How is genital herpes managed?

Answer 8

Aciclovir
- Topical lidocaine
- Paracetamol
- Avoiding intercourse with symptoms

Question 9

What is the main issue with genital herpes in pregnancy?

Answer 9

Neonatal herpes simplex infection during labour delivery

High morbidity and mortality

Question 10

How is genital herpes treated in pregnancy?

Answer 10

Before 28 weeks
Aciclovir

After 28 weeks
Aciclovir for initial infection with prophylactic aciclovir

C-section to reduce risk of vertical transmission