Sexually transmitted infection caused by the herpes simplex virus
Aetiology
HSV-1: traditionally associated with oral herpes, it is now the most common cause of genital herpes in the UK.
HSV-2: previously the most common cause of genital herpes in the UK, it is more likely to cause recurrent anogenital symptoms
Pathophysiology
After infection, the virus travels up the nearest nerve to the ganglion and remains there - explains why the infection can stay dormant for so long, as here it cannot be reached by the immune system
During the reactivation of the virus, it travels back down the nerve onto the surface of the genitals once again to cause a symptomatic outbreak
Clinical features
Primary infection
Blistering and ulceration of the external genitalia, blisters are very painful
External dysuria
Vaginal or urethral discharge
Local lymphadenopathy
Fever and myalgia
Recurrent infection
More common with HSV-2
Often overlooked/misdiagnosed
Usually unilateral, small blisters and ulcers
Minimal systemic symptoms, resolves within 5-7 days