Summary
Definição
História e exame físico
Principais fatores diagnósticos
- dysuria (in women)
- lymphadenopathy
- genital ulcer
- oral ulcer
- fever
Outros fatores diagnósticos
- tingling sensation
- headache/aseptic meningitis
Fatores de risco
- HIV infection (risk factor for clinical disease)
- use of immunosuppressive medications (risk factor for clinical disease)
- female sex (risk factor for seropositivity)
- black race (risk factor for seropositivity)
- increasing age (risk factor for seropositivity)
- high-risk sexual behavior (risk factor for seropositivity)
- lack of condom use (risk factor for seropositivity)
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- HSV polymerase chain reaction (PCR)
- viral culture
Investigações a serem consideradas
- Glycoprotein G-based type-specific serology (gG1 and gG2)
Algoritmo de tratamento
CNS involvement: encephalitis or meningitis
disseminated visceral involvement: esophagitis, pneumonitis, or hepatitis
genital disease: first episode, immunocompetent, nonpregnant
genital disease: first episode, immunocompromised, nonpregnant
genital disease: recurrent episode, immunocompetent, nonpregnant
genital disease: recurrent episode, immunocompromised, nonpregnant
genital disease: primary or first-episode, pregnant
genital disease: recurrent episode, pregnant
oral disease: first episode, immunocompetent
oral disease: first episode, immunocompromised
oral disease: recurrent episode, immunocompetent
oral disease: recurrent episode, immunocompromised
genital disease: sexually active or frequent severe recurrences, immunocompetent, nonpregnant
genital disease: sexually active or frequent severe recurrences, immunocompromised, nonpregnant
genital disease: pregnant
oral disease: frequent severe recurrences, immunocompetent
oral disease: frequent severe recurrences, immunocompromised
Colaboradores
Autores
Benjamin D. Lorenz, MD
Assistant Professor
Division of Hospital Medicine
MedStar Georgetown University Hospital
Washington
DC
Declarações
BDL declares that he has no competing interests. Since completing the 2024 review, BDL has become an employee of Moderna and has resigned as a contributor.
Agradecimentos
Dr Benjamin D. Lorenz would like to gratefully acknowledge Dr Christine Johnson and Dr Anna Wald, previous contributors to this topic.
Declarações
CJ reports funding from AiCuris; grants from Agenus, Gilead, Genocea, Sanofi, and Vical to conduct clinical research studies; and royalties from Up To Date. AW reports grants from Agenus, Gilead, Genocea, Sanofi, and Vical to conduct clinical research studies. AW receives royalties from Up To Date. AW is an NIH grant recipient (NIH AI30731 and AI071113) and a consultant for Aicuris, Eisai, and Amgen.
Revisores
Giuseppe Pizzo, DDS
Associate Professor
Department of Surgical, Oncological and Oral Sciences
School of Dentistry
University of Palermo
Palermo
Italy
Declarações
GP declares that he has no competing interests.
Paul Adamson, MD, MPH
Assistant Clinical Professor of Medicine
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles
CA
Declarações
PA declares that he has no competing interests.
Nicholas Van Wagoner, MD, PhD
Associate Professor of Medicine
University of Alabama
Birmingham
AL
Declarações
NVW declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Centers for Disease Control and Prevention. Morbidity and mortality weekly report: sexually transmitted infections treatment guidelines, 2021. Jul 2021 [internet publication].Texto completo
Patel R, Kennedy OJ, Clarke E, et al. 2017 European guidelines for the management of genital herpes. Int J STD AIDS. 2017 Dec;28(14):1366-79.Texto completo Resumo
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 220: management of genital herpes in pregnancy. May 2020 [internet publication].Texto completo
British Association for Sexual Health & HIV; Royal College of Obstetricians and Gynaecologists. Management of genital herpes in pregnancy. Oct 2014 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Syphilis
- Chancroid
- Lymphogranuloma venereum
Mais Diagnósticos diferenciaisРекомендации
- Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV
- Sexually transmitted infections treatment guidelines, 2021
Mais РекомендацииЛифлеты для пациента
Cold sores
Genital herpes
Больше Лифлеты для пациентаВойдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice
Использование этого контента попадает под действие нашего заявления об отказе от ответственности