Herpes

Question 1

Herpes Aetiology

Answer 1

• HSV type 1 and 2
• Type 1 causes cold sores
• Type 2 associated with anogenital infection

Question 2

Herpes Presentation

Answer 2

-Many cases there are no symptoms
Primary infection
-Febrile flu-like prodrome
-Tingling 
-Extensive painful crops of blisters
-Lesions usually bilateral  in primary unilateral in recurrent 
Recurrent
-Periodic reactivation
-Unilateral lesions

Question 3

Herpes Ix

Answer 3

• Viral culture
• PCR of swab from base of ulcer
• Serology can be used if persons partner has GH and wants to know if they’ve been infected

Question 4

Herpes Differentials

Answer 4

• Vulvo-vaginal candidiasis
• Other STIs
• Scabies, psoriasis, folliculitis

Question 5

Herpes Management

Answer 5

• No cure, infection life long but eventually people stop having recurrences
• Ideally refer to GUM clinic
• Supportive management: saline bathing, oral painkillers, topical lidocaine
• Oral anti-viral treatment should be given within 5 days of onset
• Aciclovir
• Can pre-prescribe as reduces severity of episodes
• Can use suppressive treatment if more than 6 attacks per year