Answer: Although the latent virus is always present in an infected individual’s body, spread is by direct contact with the virus at the site of an outbreak. Therefore, the virus can only be spread when a woman has a secondary outbreak or in the days just prior to the eruption of an ulcer. During this [...]

Answer: A primary herpes outbreak is typically more severe and lasts longer (12-21 days). Recurrent outbreaks typically last 2-5 days, and the symptoms are usually more mild. The frequency of HSV recurrence is quite variable. Some women experience a single outbreak and others have recurrences many times a year. Reference:  Stenchever MA, Droegemueller W, Herbst [...]

Answer: Herpes typically causes small vesicles that rapidly progress to characteristic shallow, painful ulcers on the labia, vaginal mucosa, cervix, and/or perineum. There may be clusters of ulcers. Inguinal adenopathy frequently is present, as well as vaginal discharge. The most common complaint is pain. The pain of an initial herpes outbreak can be so severe [...]

Answer: Herpes infection is caused by one of two herpes simplex viruses, HSV-1 and HSV-2. HSV-1 more commonly causes perioral infection (“cold sores”), and HSV-2 is more commonly isolated in genital infections. HSV-1 infections of the genitals are less likely to recur. Like other herpesviruses (e.g., herpes zoster), infection with HSV is chronic. After the [...]

Answer: Prevention, screening, and treatment of patients and their sexual partners. Discuss prevention of STDs through safe sexual practices with all at-risk women. Perform screening as part of a routine health evaluation or at the time of contraceptive management. Always treat the patient and all sexual contacts. Reference:  Baldwin HE. STD update: Screening and therapeutic [...]

Answer: Many common STDs, including HIV infection, syphilis, chlamydial infection, and hepatitis, can be asymptomatic at some stage in the disease. Screening therefore offers benefit to the individual and can also have societal benefits by identifying infected individuals and preventing the spread of the disease. KEY POINTS: LOWER GENITAL TRACT INFECTIONS Trichomoniasis and candidiasis are [...]

Answer: Chlamydia can cause a characteristic discharge, which the patient may notice or which may be noticed on exam. This mucopurulent discharge can be cultured, or the diagnosis can be made by identifying chlamydia mRNA with a genetic probe. Depending on the population studied and the definition, chlamydia is among the most common STDs. It [...]