"I have something DOWN THERE!"- Herpes in the ED: Diagnosis, Treatment, & What to tell patients

They have something DOWN THERE... No surprises, it's herpes. But making the diagnosis is the just first of many issues and questions- how do you treat it? Will it come back? How do I stop from spreading it to other partners? Is there something I can do to decrease my number of outbreaks? All great questions we should be ready to answer. In this vodcast Dr. Leger reviews this disease and these important questions.

 
 

References

  1. Aoki et al. Single-day, patient initiated famciclovir therapy for recurrent genital herpes: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2006 Jan 1;42(1):8-13 [pubmed]

  2. Benedetti, et al. Recurrence Rates in Genital Herpes after Symptomatic First-Episode Infection. Annals of Int Med. 1994 [pubmed]

  3. Cone RW et al. Extended duration of herpes simplex virus DNA in genital lesions detected by the polymerase chain reaction. J Infe. Dis. 1991;164(4):757 [pubmed]

  4. Filen et al. Duplex real-time polymerase chain reaction assay for detection and quantification of herpes simplex virus type 1 and herpes simplex virus type 2 in genital and cutaneous lesions. Sex Transm Dis. 2004;31(6):331 [pubmed]

  5. Hur, Jean. Sacral Herpes Zoster Associated with Voiding Dysfunction in a Young Patient with Scrub Typhus. Infect Chemother. 2015 Jun; 47(2): 133-136. [pubmed]

  6. Koutsky et al. Under diagnosis of genital herpes by current clinical and viral -isolation procedures. N Engl J Med. 1992;326(23):1533 [pubmed]

  7. Ramaswamy et al. Diagnosis of genital herpes by real time PCR in routine clinical practice. Sex Transm Infect. 2004;80(5):406 [pubmed]

  8. Sapna Modi et al. Single-day treatment for orolabial and genital herpes: a brief review of pathogenesis and pharmacology. Ther Clin Risk Manag. 2008 Apr; 4(2): 409-417 [pubmed]

  9. Schillinger et al. Seroprevalence of herpes simplex virus type 2 and characteristics associated with undiagnosed infection. New York City, 2004. Sex Transm Dis. 2008;35(6):599 [pubmed]

  10. Singh et al. The laboratory diagnosis of herpes simplex virus infections. Can J Infect Dis Med Microbiol. 2005 Mar-Apr; 16(2) : 92-98 [pubmed]

  11. Tronstein et al. Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection. JAMA. 2011;305)14):1441 [pubmed]

  12. Tyring, et al. A Randomized, Placebo-Controlled Comparison of Oral Valacyclovir and Acyclovir in Immunocompetent Patients with Recurrent Genital Herpes Infections. Arch Dermatol. 1998;134(2):185-191 [pubmed]

  13. Vieira-Baptista P, Lima-Silva J, Beires J, Martinez-de-Oliveira J. Lipschuitz ulcers: should we rethink this? An analysis of 33 cases. Eur J Obstet Gynecol Reprod Biol. 2016 Marl 98:149-52 [pubmed]

  14. Wald et al. Virologic characteristics of subclinical and symptomatic genital herpes infections. N Engl J Med. 1995;333(12):770 [pubmed]

  15. Wald et al. Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. N Engl J Med. 2000;342(12):844 [pubmed]

  16. Whalen et al. Sacral Myeloradiculitis: An Uncommon Complication of Genital Herpes Infection. Pediatrics July 2019, 144(1) e20182631; DOI: https://doi.org/10.1542/peds.2018-2631 [pubmed]