Genital Herpes simplex

Question 1

Previous HSV-1 infection

Answer 1

reduces the risk of acquisition of HSV-2 in future and reduces the severity of the initial HSV-2 infection if it is transmitted

Question 2

Primary HSV infection

Answer 2

More extensive and have more systemic symptoms

• lesions ~ 1 week after the sexual contact
• more extensive disease seen in women (can see erosive cervicitis)

Question 3

Recurrent infection

Answer 3

• may have prodromal itching/pain

- grouped vesicles that reappear in same area each time

Question 4

Preventing transmission

Answer 4

• usually transmitted via asymptomatic shedding

- however, if active lesions, should avoid sexual contact until reepithelialization is complete

Question 5

HIV and herpes

Answer 5

Consider immunosuppressive treatment of herpes in patients at risk of acquiring HIV as the ulcers are targets for HIV entry

Question 6

Treatment of Herpes

Answer 6

Antivirals: acyclovir, valacyclovir, and famciclovir which each reduce duration of viral shedding, time to heal, and the development of new lesions
- cool compresses can reduce inflammation

Question 7

Herpes infection during pregnancy

Answer 7

Risk is highest to pass on infection to infant when the infection initially acquired near the time of delivery
- and want to avoid delivery with active lesions

Question 8

Neonatal herpes clinical presentation patterns

Answer 8

1. SEM: skin, eyes, and mouth infections
2. CNS infections
3. Disseminated infections