A woman has numerous painful ulcers on her vulva. What is the cause?
a. Chlamydia
b. Trichomonas
c. Gardenella
d. HSV
e. EBV
answer:D
painful ulcer = HSV
painless ulcer/chancre= syphillis
mucopurulant endocervical discharge = chlamydia or gonorrhea
yellowish green discharge, petechiae = Trichomonas
fishy smell = Gardenella
HERPES SIMPLEX VIRUS OF VULVA
Etiology
• 90% are HSV-2, 10% are HSV-1
Clinical Features
• may be asymptomatic
• initial symptoms: present 2-21 d following contact
• prodromal symptoms: tingling, burning, pruritus
• multiple, painful, shallow ulcerations with small vesicles appear 7-10 d after initial infection
(absent in many infected persons); lesions are infectious
• inguinal lymphadenopathy, malaise, and fever often with first infection
• dysuria and urinary retention if urethral mucosa affected
• recurrent infections: less severe, less frequent and shorter in duration (especially with HSV-1)
Investigations
• viral culture preferred in patients with ulcer present, however decreased sensitivity as lesions heal
• cytologic smear (Tzanck smear)
multinucleated giant cells, acidophilic intranuclear inclusion bodies
• type specific serologic tests for antibodies to HSV-1 and HSV-2
• HSV DNA PCR
Treatment:
Acyclovir
No comments:
Post a Comment