Genital Herpes (Part Two)

Diagnosis

• HSV lesions have a characteristic appearance so they can be easily diagnosed with the naked eye.
• Antibody Tests
• Culture the tissue damage
• Direct fluorescent antibody test (DFA)
• Tzanck test: to see the cytopathic changes of herpetic infection
• Punch biopsy for histological examination
• Examination of cerebrospinal fluid
• Brain biopsy as well as MRI in cases of herpetic encephalitis.

Differential Diagnosis

• Urinary tract infections that may cause frequent urination, burning during urination, pain in urination, fever.
• Growth or infection of the hair follicle, but in such cases, we see the presence of erythema around the follicle which then becomes pustule and forms crusts. But there is no fever nor blisters form.
• Scratches and injuries as a result of violent sexual acts, clusters, insect bites, etc.

Complications

• Candidal vaginitis in women.
• Herpetic white discharge.
• Congenital anomalies in fetuses of pregnant women.
• IUGR and fetal prematurity
• Neonatal Herpes
• Spread of infection and life-threatening complications in sick patients, HIV, or with renal transplant.
• The spread of HSV 2 infection can lead to herpetic hepatitis, herpetic esophagitis, adrenal gland necrosis, herpetic interstitial pneumonia, herpetic cystitis, arthritis, ganglionitis, myelitis, etc.

Care!

• Do not scratch the skin wounds. Wear loose cotton clothes. Keep the affected area clean and dry.
• Do not use deodorants, perfumes or other cosmetic substances.
• Eat a diet rich in lysine amino acids such as peas, beans, cheese, nuts, soy products, red meat, pork, poultry, eggs, fish (sardines and hake).
• Do not touch the wounds with hands without gloves or wash your hands after every contact.
• You can place ice packs on the wounds to soothe the pain.

Prevention

• Improving overall health and lifestyle.
• Avoid sexual contact with multiple partners.
• Avoid sexual relations if you have skin lesions in the genital areas.
• Use condoms to reduce the transmission of the disease.
• Abstain from oral or anal relations.
• Performing surgery for childbirth in pregnant women with active infection.
• Avoid sexual contact with a partner who has active lesions in the last months of pregnancy.

Treatment

• Initial treatment, if there are symptoms such as wounds start therapy with antiviral for at least 7 to 10 days.
  After the completion of this therapy, there are two possibilities for the continuation of treatment:
• Intermittent treatment, antivirals that are taken in case of symptom recurrence for 2-5 days which make their transition faster and easier.