Herpes Simplex Virus-2: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*multiple painful lesions | *multiple painful lesions | ||
*no buboes ( | *no buboes (occasionally shoddy [[lymphadenopathy]]) | ||
*more common in | *more common in Black patients | ||
*starts with small clumps of blisters that may have been preceded with local pain, tingling, itching, and burning | *starts with small clumps of blisters that may have been preceded with local pain, tingling, itching, and burning | ||
*+/- | *+/- constitutional symptoms ([[fever]], [[fatigue]], [[myalgia]]s, [[headache]]s) | ||
[[File:HSVmale.jpg|thumb|200px]] | [[File:HSVmale.jpg|thumb|200px]] | ||
| Line 17: | Line 17: | ||
{{STD DDX}} | {{STD DDX}} | ||
== | ==Evaluation== | ||
*Clinical diagnosis if visible lesions present. | *Clinical diagnosis if visible lesions present. | ||
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<references/> | <references/> | ||
[[Category: | [[Category:Dermatology]] | ||
[[Category: | [[Category:Urology]] | ||
[[Category:ID]] | [[Category:ID]] | ||
Revision as of 22:47, 27 September 2019
Background
Clinical Features
- multiple painful lesions
- no buboes (occasionally shoddy lymphadenopathy)
- more common in Black patients
- starts with small clumps of blisters that may have been preceded with local pain, tingling, itching, and burning
- +/- constitutional symptoms (fever, fatigue, myalgias, headaches)
Differential Diagnosis
Sexually transmitted diseases
- Chancroid
- Chlamydia trachomatis
- Granuloma inguinale
- Hepatitis B
- Herpes Simplex Virus-2
- HIV
- Human papillomavirus
- Lymphogranuloma venereum
- Neisseria gonorrhoeae
- Trichomonas
- Syphilis
Evaluation
- Clinical diagnosis if visible lesions present.
Management
Initial Episode[1][2]
- Acyclovir OR
- 400mg PO q8hrs x 7-10 days
- or 200mg PO 5x/day x 7-10 days
- Valacyclovir 1g PO q12hrs x 7-10 days OR
- Famciclovir 250mg PO q8hrs x 7-10 days
Recurrence[1]
- Acyclovir OR
- 400mg PO q8hrs x 5 days
- or 800mg PO q12hrs x 5 days
- or 800mg PO q8hrs x 2 days
- Valacyclovir OR
- 500mg PO q12hrs x 3 days
- or 1g PO qd x 5 days
- Famciclovir
- 125mg PO q12hrs for 5 days
- or 1g PO q12hrs for 1 day
- or 500mg PO once, followed by 250mg PO q12hrs for 2 days
Suppressive Therapy[1]
- Acyclovir 400mg PO q12hrs daily OR
- Famciclovir 250mg PO q12hrs daily OR
- Valacyclovir 500mg-1g PO daily (500mg may be less effective)
Disposition
- Generally outpatient
See Also
References
- ↑ 1.0 1.1 1.2 Workoski KA and Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recommen and Reports. 2015; 64(3):1-140.
- ↑ https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf