Genital herpes

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1A94.0

Primary or secondary infection due to herpes simplex virus II (in 80-90% of cases) or HSV I (10-20%).

  • Vulvovaginitis herpetica
  • Cervicitis herpetica
  • Proctitis herpetica
  • Urethritis herpetica
  • Balanitis or balanoposthitis herpetica

Transmission through skin to skin contact, mostly sexual intercourse / oral sex.

Genital redness and swelling with (often grouped localised) herpetiform vesicles, erosions and haemorrhagic crusts, sometimes painful, often severe itching; reduced AZ, fever, restlessness, vomiting.

  • Clinical manifestion (exclude meningismus)
  • If needed:
    • PCR or microtrack
    • Biopsy is rarely helpful

  • Possible "peripartum" infection of the newborn in women
  • Secondary infection with bacteria or candida

  • Healing after 3-4 weeks
  • Recurrences occur mainly in the first year after initial infection, with males showing symptoms more frequently

  1. Corey, L., Genital Herpes Simplex Virus Infections: Clinical Manifestations, Course, and Complications. Annals of Internal Medicine, 1983. 98(6): p. 958.
  2. Corey, L., et al., A Trial of Topical Acyclovir in Genital Herpes Simplex Virus Infections. New England Journal of Medicine, 1982. 306(22): p. 1313-1319.
  3. Corey, L., et al., Once-Daily Valacyclovir to Reduce the Risk of Transmission of Genital Herpes. New England Journal of Medicine, 2004. 350(1): p. 11-20.
  4. Fiddian, A.P., et al., Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy. Journal of Antimicrobial Chemotherapy, 1983. 12(suppl B): p. 67-77.
  5. Gupta, R., T. Warren, and A. Wald, Genital herpes. The Lancet, 2007. 370(9605): p. 2127-2137.
  6. Jarratt, M., Herpes Genitalis and Aseptic Meningitis. Arch Dermatol, 1974. 110(5): p. 771.
  7. Kaplowitz, L.G., Prolonged continuous acyclovir treatment of normal adults with frequently recurring genital herpes simplex virus infection. The Acyclovir Study Group. JAMA: The Journal of the American Medical Association, 1991. 265(6): p. 747-751.
  8. Lautenschlager, S. and W. Kempf, Herpes genitalis. Der Hautarzt, 2000. 51(12): p. 964-983.
  9. Mercolini, F., et al., Congenital disseminated HSV-1 infection in preterm twins after primary gingivostomatitis of the mother: case report and review of the literature. Z Geburtshilfe Neonatol, 2014. 218(6): p. 261-4.
  10. Peña, K.C., et al., Genital Herpes Simplex Virus Type 1 in Women: Detection in Cervicovaginal Specimens from Gynecological Practices in the United States. J. Clin. Microbiol., 2009. 48(1): p. 150-153.
  11. Rabenau, H.F. and H.W. Doerr, Genitaler Herpes und HSV-Transmission bei HIV-Patienten. Hautarzt, 2007. 59(1): p. 11-17.
  12. Shim, T., et al., Atypical Presentation of Genital Herpes Simplex (HSV-2) in Two Patients with Chronic Lymphocytic Leukemia. Acta Dermato Venereologica, 2014. 94(2): p. 246-247.
  13. Slomka, M.J., et al., A comparison of PCR with virus isolation and direct antigen detection for diagnosis and typing of genital herpes. J. Med. Virol., 1998. 55(2): p. 177-183.
  14. Spruance, Spotswood L., et al., Application of a Topical Immune Response Modifier, Resiquimod Gel, to Modify the Recurrence Rate of Recurrent Genital Herpes: A Pilot Study. The Journal of Infectious Diseases, 2001. 184(2): p. 196-200.
  15. Villa, A. and B. Berman, Genital Herpes Infection: Beyond a Clinical Diagnosis. SKINmed, 2003. 2(2): p. 108-112.