Herpes genitalis (genital herpes) is a sexually transmitted disease caused by the herpes simplex virus (HSV-1 or HSV-2).
The clinical presentation depends on the type of infection; the primary genital herpes is characterized by severe, prolonged symptoms. The incubation period ranges from 1 day to 3 weeks. The general symptoms are seen most commonly on first 3-4 days, which includes fever, malaise, headache, muscle pain. Also, locally there is pain, dysuria, itching, vaginal and urethral discharge and tender lymph nodes .
In women, the herpetic eruption is seen on external genitalia. Cervix is involved about 70-80% of the times. It is red, edematous and painful. There is dysuria which can cause urine retention and urethritis. HSV is isolated in the urine when tested. The moistness of the genital area makes the vesicles rupture leaving an ulcer which is painful.
In men, the herpetic vesicles are found on glans penis, shaft of penis; the prepuce and scrotum may be involved. The buttocks and the thighs are also not spared. It causes herpetic urethritis and herpetic prostatitis when involving rectum and perianal area. Women are affected more severely than men.
Recurrence is common especially in patients with severe primary infection. There is prodrome in which the patient experiences pain, burning and tenderness at the site of eruption. The lesion may heal in 7-10 days. The symptoms are again more severe in women than men .
The diagnosis is based on the examination of the patient and the signs and symptoms given by him/her. Tissue culture is the confirmatory test to establish the diagnosis of infection with herpes. The isolation of virus is best done within 48 hours of inoculation. The herpes lesion can be seen under the microscope within an hour for the histological appearance of herpes. The eosinophillic intra nuclear inclusion bodies in multi nucleated giant cells and epithelial cells are characteristic of herpes. Polymerase chain reaction technique is used to detect HSV DNA .
The general symptoms like fever, malaise are treated symptomatically. Proper care of the wound is to be done and secondary bacterial or fungal infection should be treated. The dermatologist should be taken into consultation.
Prognosis is bad as once infected with HSV, the chances of recurrence are very high. If antiviral therapy is administered in time the disease may resolve quickly. Also, one must maintain a strong immunity to reduce the chances of recurrence.
Genital Herpes is caused by Herpes Simplex Virus 1 and 2. Out of these, HSV-1 is usually associated with orofacial disease and HSV-2 is associated with genital disease. There are three types of clinical HSV infection: primary, non primary and recurrent .
Primary infection: in which there is no serological evidence of previous infection with neither HSV 1 nor 2 and it is a newly acquired infection.
Non-primary, first episode: occurs when there has been a history of previous infection with some other form of herpes and there is a newly acquired genital herpes. Primary and non-primary infection usually occurs due to unprotected sex with the infected partner, frequent change of sexual partners, previous infection with sexually transmitted disease, impaired immunity due to immune compromised disease like HIV/AIDS.
Recurrent: in this there is recurrence of same type of HSV infection again. HSV2 is more common. It usually occurs when the patient is stressed, tired and menstruating. Recurrence is also seen when the immunity is low due to HIV infection and in immune compromised individual due to organ transplant or stem cell transplantation .
Genital Herpes is seen worldwide. It is more common between ages 18 to 45 which correlate directly with sexual activity. Also, it is seen more frequently in lower socioeconomic groups. It is more prevalent in women than men .
Herpes Simplex Virus 1 and 2 are the cause of genital herpes. However, infection with HSV 2 is the common cause of genital herpes. HSV is a double stranded DNA virus which has the capacity to replicate in the nervous system. The genital herpes virus infects the sacral nerve root ganglia [S2-S5].
Human beings are the natural reservoir of this virus and the person in close contact with such an infected individual gets affected due to unprotected sex. The virus gets inoculated on the mucosal surface of cervix or through the cracked skin into the host. It can be transmitted via mother’s genital tract to the new born baby during the process of delivery  .
Herpes virus is so common in the metropolitan city that it is extremely difficult to avoid it. One can prevent it by avoiding contact with infected individuals who shed the virus in salivary or genital secretion. One can use condom to prevent it. However, you can acquire it if it is found outside the area covered by condom. Also, oral contact and oro genital contact should be avoided. Caesarean section is advised to the women who have genital herpes at the time of delivery. One must increase the immunity to decrease the chances of recurrence. Antiviral therapy should be taken. However therapies to suppress the infection and HSV vaccine are still under trials .
Genital Herpes is a fairly common ulcerative disease which is seen around the world. It is caused by Herpes Simplex Virus (HSV). Most often patients remain asymptomatic. However, lymphadenopathy and systemic symptoms do occur. There are three types of clinical infections.
Diagnosis is done by clinical history followed by serological test, polymerase chain reaction and viral culture. Recurrence is common but its intensity can be reduced by administrating oral anti virals. One must avoid sexual intercourse when symptomatic.
Genital herpes is caused by herpes simplex virus (HSV) 1 and 2. Infection with HSV 2 is more common. The patient may acquire infection through an infected person by coming in contact with the saliva or genital secretion of such person. The neonate is infected through the infected mother who passes the virus through the genital tract to the baby during delivery. The patient may be asymptomatic or may have symptoms of pain, malaise, fever, headache, painful urination with retention.
The lesion may be seen anywhere around and in the genital region of the male or female who are infected. Females tend to have more severe symptoms than men. Treatment includes symptomatic care and antiviral therapy.
It can be prevented by avoiding contact with the infected individual and wearing condom can minimize the risk of exposure. A healthy immunity decreases the chances of infection. HSV vaccine is still under research.