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TH 12 Health: Genital Herpes [Logged in view]
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The netpaper about Elftowners, by Elftowners, for Elftowners.
DISCLAIMER: I am still an undergraduate medical student who is not yet fully qualified to practice medicine, as I have still much to learn. For the articles I write here, I use some of the most reliable textbook and online sources. Thus I am only advising people, not treating them whatsoever. If you have read anything in my articles, don’t go ahead and use it in accordance, for though the information is reliable, the need to see a fully qualified legally certified medical practitioner is mandatory. Also, note that medicine is an ever-advancing science, for example what might have been medically acceptable this month may become an out-of-date practice next week if a new and improved regimen takes its place. This said, these articles are only written for the sole purposes of information, myth-busting, and advice. They do not override the necessity of seeing a doctor if your health is at stake.</i>
WARNING: At the end of this article there are some clinically intimate pictures which show the affected genitalia of patients. They are meant for informative and scientific purposes. Steel yourself if you cannot stand the sight of organs damaged by diseases or if you are offended by seeing genitalia.
Genital Herpes
By [The Red Baron]
Genital herpes is one of the most common sexually transmitted diseases (STDs) worldwide. The peak incidence is among teenagers and those in their early twenties.
Causative Organism
The causative organism is the herpes simplex virus (HSV); which is further classified into two types, HSV-1 mainly affects the mouth and is termed herpes labialis (labium being Latin for lip) or cold sore.
Briefly stated, almost 70% of the general population has had an HSV-1 infection. The virus causes the first infection, then after healing, it persists in the human body in a latent (inactive) state, and becomes activated when the person’s immunity is down. As a general rule, it is a simple condition and resolves spontaneously.
HSV-2, however, is termed genital herpes (or herpes genitalis), as it is the one that causes the genital infection mainly as well as the dangerous and life-threateni
ng infection of babies born to mothers with active genital herpes.
This distinction is not rigid, as HSV-1 can cause the same clinical conditions as HSV-2 and vice versa.
Clinical Features
Genital herpes usually comes with a package of general symptoms (of varying severity) which include fever, headache, and muscle pains. After this, multiple painful shallow ulcers develop and may coalesce, within 10-14 days, the ulcers crust and dry, heralding healing. The genital ulceration may also be atypical in pattern.
The disease spreads by sexual intercourse, in males the ulcers appear on the penis, in females, the vulva and uterine cervix are often affected. Oral, pharyngeal, and rectal surfaces are also susceptible.
In case of rectal infection, proctitis (rectal inflammation) occurs.
In case of recurrence of genital herpes, there is only local genital involvement, general symptoms are rare.
In case of immune system suppression (AIDS patients included), the clinical picture is more severe and tends to recur more frequently. Also, viral spread in the body has been noted.
HSV infection of pregnant women very rarely affects the fetus during pregnancy, but in case of active genital of the mother at the time of delivery, a caesarean section is usually done to deliver the baby. In case the mother has active genital herpes, medications taken 4 weeks before delivery may prevent infection recurrence at delivery. It is mandatory for a pregnant woman not to take any medication unless absolutely indicated by her treating physician or gynaecologist as medications might have a hazardous effect on the fetus.
Treatment and Prevention
A medication is available to treat herpes infections; symptomatic treatment is also available and these should only be prescribed by your treating physician.
In case one of the partners has active herpes, the couple is advised to refrain from sexual intercourse. Condoms might not be effective protection as the virus may enter the body from a location outside the covered penile area. The patient’s sexual partners should also be examined.
Figures:
Figure 1: Severe primary HSV infection with penile swelling. Note the crusting on the multiple small ulcers. Image is courtesy of Connie Celum and Walter Stamm, and the Seattle STD/HIV Prevention Training Centre at the University of Washington. http://depts.washington.edu/nnptc/online_training/std_handbook/gallery/index.html
Figure 2: Atypical genital ulcer in an HSV positive patient. The clinical diagnosis for this case though is a different condition from genital herpes. The purpose of this image is to demonstrate the atypical ulcer. Image is courtesy of Connie Celum and Walter Stamm, and the Seattle STD/HIV Prevention Training Centre at the University of Washington. http://depts.washington.edu/nnptc/online_training/std_handbook/gallery/index.html
Figure 3: Recurrent HSV lesions on a patient’s penis, note the vesicles and ulceration. Image is courtesy of Connie Celum and Walter Stamm, and the Seattle STD/HIV Prevention Training Centre at the University of Washington. http://depts.washington.edu/nnptc/online_training/std_handbook/gallery/index.html
References:
Clinical Medicine, Kumar and Clark, 5th Edition
http://depts.washington.edu/nnptc/online_training/std_handbook/gallery/index.html
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