Herpes Simplex

Question 0

History questions

Answer 0

Hx of STI
Sexual activity
Multiple partners
Use of barrier
Previous outbreaks
Pain during urination (females)
Sexual activity while under the influence.
Lesions?

Fever, Headache, Malaise, Myalgia, Dysuria, Lymphadenopathy.

Question 1

Herpes Simplex 1 & 2

Answer 1

Can lay dormant for years without active lesions.
An asymptomatic person can be infectious while shedding virrus.
1 in 6 Americans are infected with genital herpes, 48% of african american females infected, and 1 in 3 females over 30 infected.
Incidence increase with age.

Question 2

Recurrent infection

Answer 2

Prodrome of pain and paresthesia over area of eruption.
Burning genital pain.
Lesions that resolve in 7 to 10 days.

Question 3

Physical

Answer 3

EENT - sclera / conjunctiva clear no dc,
Oral mucosa moist , no lesions, no exudate.
no LAD, No thyroid masses.
Abd - NT, No masses
Urogenital - + vulvar lesions circular on erythematous base.
Penial lesions same, w/ crusting and few with clear dc. No epididymal tenderness.
Rectal - Males check prostate, No lesions
Skin - check for lesions, palms soles,
LAD - check inguinal LAD.

Question 4

Diagnosis

Answer 4

Herpatic lesions penis, or vulva.
vulvar lesions consistent with HSV
Penil lesions consistent with HSV

Question 5

Plan

Answer 5

Labs: Viral tissue culture. DNA prep.
Acyclovir 400 mg tid po SE discussed
Education: Safe sex, partner screening, disease informaiton