infectious diseases
Genital Herpes
Key Points
After the initial infection, HSV remains dormant in nerve ganglia, from which it can periodically reactivate. Transmission may occur through contact with the lesions, but viral shedding and transmission can also occur when lesions are not apparent (asymptomatic shedding). Most initial infections do not cause symptoms, but primary genital lesions are usually more painful, prolonged, and widespread than recurrent genital lesions. Diagnose based on characteristic genital lesions in patients with lesions and confirm by culture, PCR (preferred), and/or serologic tests for HSV. Primary and recurrent eruptions can be treated with oralacyclovir,valacyclovir, orfamciclovir. If pregnant women have genital herpes, consider givingacyclovirstarting at 36 weeks gestation to reduce the risk of a recurrence and transmission to the neonate during delivery. 