Herpesvirus Infections
Herpes simplex virus (HSV) is a common sexually transmitted infection. An HSV outbreak often manifests as a vesicular eruption on the mucous membranes of the vulva and can extend to keratinized skin. Systemic symptoms may accompany the vesicular eruption.
- PDF / 602,345 Bytes
- 5 Pages / 504.567 x 720 pts Page_size
- 10 Downloads / 181 Views
42
Sarah Shaffer and Colleen K. Stockdale
42.1 Herpes Simplex Herpes simplex virus (HSV) is a common sexually transmitted infection. Herpesviruses cause latent, recurring or lytic infections. Nine herpesvirus types are known to infect humans (Table 42.1). Of them HSV-1 and HSV-2, both can cause orolabial herpes and genital herpes. The duration, severity, and symptomatology may vary, but overall the visible manifestation of genital herpes simplex is painful, grouped vesicles that quickly erode to superficial, coalescing ulcers. Notable risk factors include a higher number of lifetime sexual partners. There are initial infection with HSV is usually unrecognized, but the primary outbreak is often worse than recurrent outbreaks. The primary outbreak usually begins within a week of initial infection and is manifested by fever, malaise, and regional lymphadenopathy. A vesicular eruption occurs on the mucous membranes of the vulva and may extend to keratinized skin (Fig. 42.1). Small (1–3 mm) scattered or grouped vesicles are delicate and quickly evolve to well-demarcated erosions with crusting; the latter is the more common clinical finding (Figs. 42.2 and 42.3). Unusually large or long-standing lesions should raise suspi-
S. Shaffer · C. K. Stockdale (*) Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA e-mail: [email protected]
Table 42.1 Types of human herpes viruses Herpes number Name HHV-1 Herpes simplex virus-1 (HSV-1) HHV-2 Herpes simplex virus-2 (HSV-2) HHV-3 Varicella zoster virus (VZV) HHV-4 Epstein–Barr virus (EBV) HHV-5 Cytomegalovirus (CMV) HHV-6A and 6B Roseolovirus, Herpes lymphotropic virus HHV-7 HHV-8 Kaposi’s sarcoma-associated herpesvirus
Fig. 42.1 Herpes genitalis covering the mons pubis, in a vesicular pattern. Courtesy of Professor Jacob Bornstein
cion of an associated HIV infection (Fig. 42.4). Lesions may take several weeks to heal completely; superinfection is a risk during this time. Other complications related to severe pain and/or edema can include dysuria, urinary retention, and dehydration. It should be
© Springer International Publishing AG, part of Springer Nature 2019 J. Bornstein (ed.), Vulvar Disease, https://doi.org/10.1007/978-3-319-61621-6_42
277
278
Fig. 42.2 Herpes genitalis, erosions developing on the labia minora and majora, where the vesicles rupture. Courtesy of Professor Jacob Bornstein
S. Shaffer and C. K. Stockdale
Fig. 42.4 Herpes genitalis. Large and long-standing erosions associated with HIV infection. Courtesy of Professor Jacob Bornstein
Fig. 42.5 Herpes genitalis erosions on the labia minora. Courtesy of Dr. Colleen Stockdale
Fig. 42.3 Herpes genitalis, erosions on the labia minora and majora. Courtesy of Diane Elas
noted, however, that a primary outbreak may be mild enough to be subclinical; these patients may not be aware of their herpes simplex virus infection. After initial infection and/or outbreak, HSV lies dormant in the dorsal root ganglion and will reactivate causing recurrent outbreaks that are
u
Data Loading...
