Genital herpes is a sexually transmitted disease (STD), mainly HSV-2, and rarely HSV-1, and is one of the common STDs. Genital herpes can recur and has a significant impact on the health and psychological well-being of patients; it can also infect newborns through the placenta and birth canal, leading to congenital infection in newborns. Therefore, this disease is also one of the more serious public health problems, should pay attention to its effective prevention and treatment.
A. Causes of genital herpes
Genital herpes is mainly caused by herpes simplex virus (HVS) infection, 90% of which is caused by HVS-2. The main source of infection is genital herpes patients and asymptomatic virus carriers. hvs-2 invades the epithelial cells through the broken mucosa or skin to replicate and spreads to the surrounding cells, causing damage to the infected epidermal cells and causing an inflammatory response. Patients produce antibodies after infection and some viruses are cleared by the host immune response process, but some residual viruses are transmitted via peripheral nerve axons into the sacral ganglia and remain latent for a long time. Some factors, such as immunosuppression, trauma, infection, menstruation, stress, exertion and cold, can revive the latent HSV, and the virus returns to the skin and mucosa of the affected area along the affected nerve roots, causing recurrence. In Chinese medicine, it is called “hot sores” and “fire sores”.
The clinical manifestations of genital herpes are.
1, primary genital herpes
(1) Incubation period of 3 to 14 days.
(2) clusters or scattered small blisters around the external genitalia or anus, which break down after 2 to 4 days to form vesicles or ulcers, with self-induced itching or pain.
(3) Enlarged inguinal lymph nodes with pressure pain.
(4) Patients often have systemic symptoms such as fever, headache, and malaise.
(5) The duration of the disease is about 2~3 weeks.
2.Recurrent genital herpes
Recurrent genital herpes is lighter and shorter in duration than the primary lesions.
(1) local burning sensation, pins and needles or abnormal sensation before the onset of the rash.
(2) clusters of small blisters around the external genitalia or anus that quickly break down to form vesicles or shallow ulcers, with milder self-conscious symptoms.
(3) The duration of the disease is 7 to 10 days.
How to confirm the diagnosis of genital herpes?
(1) Cytological examination (Tzanck smear): a slide at the base of the blister is used to make a print with Wright stain or Giemsa stain, and characteristic multinucleated giant cells or intranuclear viral inclusions can be seen under the microscope.
(2) Detection of viral antigens: specimens were taken from the lesions and herpes simplex virus antigens were detected by direct fluorescence with monoclonal antibodies or enzyme-linked immunosorbent assay (ELISA).
(3) Viral culture: Specimens taken from the lesion are cultured for the virus and are positive for the growth of herpes simplex virus. This method is mainly used for research.