(Hawkins, J., et al, 2014) Primary Infections can present multiples lesions in both males and females. It is most commonly seen in the male’s penis, buttocks, thighs and females’ labia, fourchette, cervix, buttocks, thigh, nipples.
-Dysuria on both males and females
-Headaches (can be a sign of Herpes Meningitis)
If this is a recurrent genital lesions- it is less painful, no systemic symptoms , unilateral and will present with prodromal symptoms like itching, burning and/or tingling at site where lesions appear. Primary Infection:
-Check temperature and blood pressure.
-Examination of the genitalia will hsow vesicular lesions containing cloudy liquid or erythematous base. Vesicles will break, lesions will coalesce forming ulcerative lesions with irregular borders, macerated if in moist areas.
-Male and female lesions are painful and examination can be difficult
-Groin : Inguinal adenopathy may be present.
-Abdomen: Bladder distension, secondary to urinary retention may be presented most commonly found in women.
-Check for atypical presentations as cystitis, meningitis, encephalitis, urethritis, ocular lesions. May include HSV Types 1 and 2. Scrape lesions for samples for:
1. Virology culture with typing
2. Genital lesions- consider GC culture, serology test for syphilis, Chlamydia test ( may need to wait until follow- up visit if infection is severe.
3. Herpes can be diagnosed through tissue…