Infectious Disease and STIs

Question 1

What are the 2 type of herpes simplex?

Answer 1

HSV 1 - mouth
HSV 2 - genital

Question 2

Presentation of herpes simplex?

Answer 2

Ulcers or blistering lesions
Neuropathic pain –> tingling, burning
Flu like symptoms
Inguinal lymphadenopathy
Dysuria

Question 3

Investigations for herpes simplex:

Answer 3

PCR of vesicular fluid

Question 4

Management of herpes simplex (non-pregnant):

Answer 4

Oral aciclovir 200mg, 5x per day for 5-10 days

Symptomatic - analgesia, saline bathing, topical lidocaine 2%

Question 5

Management of herpes simplex in pregnancy:

Answer 5

< 28 weeks - aciclovir during initial infection and prophylactic acyclovir from 36 weeks

> 28 weeks - aciclovir during initial infection and continued prophylaxis

Question 6

What is a complication of herpes in pregnancy?

Answer 6

Can cause bone damage or death for neonate if not treated

Question 7

What is shingles?

Answer 7

Localised blistering and painful rash causes by reactivation of varicella zoster virus

Question 8

Causes and risk factors for shingles:

Answer 8

Anyone who has had chickenpox can develop

Increased risk with cancer

Immunodeficiency

Question 9

Presentation of shingles:

Answer 9

Dermatomal distribution - blisters confined to cutaneous distribution

Unilateral

Pain –> rash
Red papules –> blisters/pustules –> shingles

Question 10

Management of shingles:

Answer 10

Acyclovir within 1-3 days of onset

Zostavax (HZV vaccine) for > 70 year olds

Question 11

When should HIV testing be performed in asymptomatic patients?

Answer 11

4 and 12 weeks after possible exposure