Herpes Simplex Virus-2

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)
HSVmale.jpg

Differential Diagnosis

Sexually transmitted diseases

Evaluation

  • Clinical diagnosis if visible lesions present.

Management

Initial Episode[1]

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]

Disposition

  • Generally outpatient

See Also

References

  1. 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.