MSRA: Genital Herpes

Question 1

What is the management of primary infection prior to 28 weeks?

Answer 1

GUM Referral
Prompt treatment with Aciclovir
Aim for vaginal delivery
Continued course of Aciclovir from 36 weeks to delivery

Question 2

What is the management of primary infection after 28 weeks?

Answer 2

GUM referral
Prompt treatment with Aciclovir which is continued until delivery
Delivery by Caesarean section

Question 3

What is the management of recurrent genital herpes?

Answer 3

Consider treatment with Aciclovir - the majority of episodes self-resolve
C section is not routinely recommended
Low risk of neonatal infection from vaginal delivery, even if lesions are present at the time of delivery

Question 4

What is the presentation of genital herpes?

Answer 4

Blistering and ulceration of the external genitalia or perianal region
Tingling neuropathic pain
Dysuria
Tender inguinal lymphadenopathy

Question 5

How is HSV detected?

Answer 5

PCR from swabs taken from the base of the lesion

Question 6

What is the management of genital herpes?

Answer 6

Analgeisa, topical anaesthetic ointment
Aciclovir can be given within 5 days of the start of the episode

Aciclovir is given to help reduce the severity and duration of symptoms at the time of primary infection or recurrence