Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
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LETTER TO EDITOR
Year : 2008  |  Volume : 29  |  Issue : 1  |  Page : 48-49
 

Florid manifestions of recurrent herpes genitalis in seronegative patient


Department of Dermatology and Venereology and Leprosy, Padmashree Dr. D. Y. Patil Hospital and Research Centre, Navi Mumbai, India

Correspondence Address:
Chavan Nisarg
Department of Dermatology and Venereology and Leprosy, Padmashee Dr. D. Y. Patil Hospital and Research Centre, Nerul, Navi Mumbai - 400706
India
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How to cite this article:
Nisarg C, Manjyot G, Sharmila P. Florid manifestions of recurrent herpes genitalis in seronegative patient. Indian J Sex Transm Dis 2008;29:48-9

How to cite this URL:
Nisarg C, Manjyot G, Sharmila P. Florid manifestions of recurrent herpes genitalis in seronegative patient. Indian J Sex Transm Dis [serial online] 2008 [cited 2020 Jul 2];29:48-9. Available from: http://www.ijstd.org/text.asp?2008/29/1/48/42720


Sir,

Herpes genitalis is a viral infection chiefly caused by HSV-2 and sometimes by HSV-1. It is characterized by multiple grouped vesicles on an erythematous base present over the genitals. Recurrent attacks are known to be mild and even asymptomatic; however, severe recurrent attacks may be seen in immunocompromised patients. We report a case of severe recurrent herpes genitalis in an immunocompetent patient.

A 42-year-old married female presented with chief complaints of severe burning and painful eruptions over the genitals since one day. Patient had severe itching over the genitals a day prior to the onset of rash. The eruption was associated with high-grade fever. There was a history of similar complaints in the past. Also, there was a history of similar complaints in her husband.

On examination, she had multiple tiny grouped vesicles over the labia majora, minora, and pubic region associated with profuse vaginal discharge [Figure 1]. Inguinal lymphnodes were enlarged and tender. A Tzanck smear from the lesion showed multinucleated giant cells. Serological tests for syphilis and HIV were negative in the patient.

A final diagnosis of recurrent herpes genitalis was made. The patient was treated with Acyclovir 400 mg orally three times a day for seven days. The lesion responded well and showed good healing [Figure 2].

In the developing world genital herpes is becoming a common cause of genital ulcer disease, especially in countries with high prevalence of HIV infection. Most infections are recurrent and tend to reappear at or near the same location. [1],[2] However, more than half of the patients who have had a primary attack of herpes genitalis do not experience clinically apparent outbreaks, although they may have episodes of viral shedding and can transmit the virus to their sexual partners. [1],[3]

Recurrent clinical outbreaks are preceded by prodrome of pain, itching, tingling, burning, or parasthesia. [2],[4] Recurrent clinical outbreaks are milder, but florid manifestations are more commonly seen in seropositive patients. [1],[4] However, our patient, inspite of being seronegative presented with recurrent herpes genitalis with very severe and florid attacks as those of primary attack.

 
   References Top

1.Benedetti J, Carey L, Ashiey R. Recurrence rates in genital herpes after symptomatic first episode infection. Ann Intern Med 1994;121:847-54.  Back to cited text no. 1    
2.Cautenschlager S, Eichmann A. The heterogeneous clinical spectrum. Dermatology 2001;202:211-9.  Back to cited text no. 2    
3.Beauman JG. Genital herpes: A review. Am Fam Physician 2005;72:1527-34.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Kaufman RH, Gardner HL, Rawls WE, Dixon RE, Young RL. Clinical features of herpes genitalis. Cancer Res 1973;33:1446-51.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]


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  [Figure 1], [Figure 2]



 

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