Herpes - genital; Herpes simplex - genital; Herpesvirus 2; HSV-2
Many people with HSV-2 infection never have sores, or they have very mild symptoms that they do not even notice or mistake for insect bites or another skin condition.
If signs and symptoms do occur during the first outbreak, they can be quite severe. This first outbreak usually happens within 2 weeks of being infected.
Generalized or whole-body (systemic) symptoms may include:
Genital symptoms include the appearance of small, painful blisters filled with clear or straw-colored fluid. They are usually found:
Other symptoms that may occur include:
A second outbreak can appear weeks or months after the first. It is almost always less severe and shorter than the first outbreak. Over time, the number of outbreaks may decrease.
Once a person is infected, however, the virus hides within nerve cells and remains in the body. The virus can remain "asleep" (dormant) for a long period of time (this is called latency).
The infection can flare-up or reactivate at any time. Events that can trigger latent infection to become active and bring on an outbreak include:
Attacks can recur as seldom as once per year, or so often that the symptoms seem continuous. Recurrent infections in men are generally milder and shorter than those in women.
Tests can be done on skin sores or blisters to diagnose herpes. These tests are most often done when someone has a first outbreak and when a pregnant women develops genital herpes symptoms.
Bernstein H. Maternal and perinatal infection - viral. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2007: chap 48.
Centers for Disease Control and Prevention. Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR. 2006;55(RR-11):1-94.
Cerink C, Gallina K, Brodell RT. The treatment of herpes simplex infections: an evidence-based review. Arch Intern Med. 2008;168(11):1137-44.
Gupta R, Warren T, Wald A. Genital herpes. Lancet. 2007;307(9605):2127-37.
Lebrun-Vignes B, Bouzamondo A, Dupuy A, Guillaume JC, Lechet P, Chosidow O. A meta-analysis to assess the efficacy of oral antiviral treatment to prevent genital herpes outbreaks. J Am Acad Dermatol. 2007;57(2):238-46.
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