Atypical herpes. Clinical forms of genital herpes. Classification by clinical form. How to protect the unborn child from the disease

Genital herpes affects both women and men. The virus is sexually transmitted and is considered quite resistant to the environment - at a temperature of 36 degrees, it fully retains its activity for 20 hours. Medical statistics claim that every fifth inhabitant of the Earth has already become its prey (the ICD-10 code for this disease is A60), but many of those infected do not even suspect that they have such a problem - the disease is often asymptomatic. However, an infection is an infection, and if it somehow manifests itself, you need to know how to deal with it.

Causes of herpes on the genitals and pubis

There are several types of herpes virus, only two of them cause genital: HSV-1 and HSV-2 (HSV stands for "herpes simplex virus"). The first gives 20, and the second - 80 percent of infections. Rashes appear on the skin and mucous membranes - on the pubis, in the inguinal region, on the genitals, sometimes on the thighs and buttocks. About herpes on the pope in the next article.

Here reasons why a person gets sick:

weakened immune system;
ignoring hygiene standards;
early onset of sexual activity;
frequent change of sexual partners, randomness of contacts;
a person already has any sexual infections that make the body more vulnerable.

At risk are young people from 16 to 22 years old who start sexual relations. The risk of infection is also high in adults aged 30-35 who are already quite experienced in sex and do not consider it necessary to use contraceptives. If we talk about the preferences of the virus by gender, then herpes is more likely to choose the female body - it is more susceptible to hormonal changes and the associated weakening of the immune system (for example, before menstruation).

How is it transmitted and how can you get infected

Infection usually occurs through sexual contact - traditional, anal or oral. But there are other ways of transmitting the virus:

airborne (provided that the person who has been infected has damaged mucous membranes or has open wounds);
from mother to baby during childbirth;
self-infection (a person transfers the infection from inflamed areas of the body to his own genitals);
blood transfusion carried out without proper precautions;
household way (in which pathogens enter the body of another victim through an open wound on the skin from a wet towel, handkerchief or bathing suit of a sick person).

The degree of contagiousness of genital herpes is extremely high: if one partner is infected, and his disease is in an acute stage, then the second partner will get sick after sexual contact with a 100% "guarantee".

Primary genital herpes can reveal itself as characteristic manifestations 3-14 days after infection. Symptoms of the disease persist in one person - 1-2 weeks, in another - more than a month (depending on the state of health and the reliability of immunity). All this time, the person is already contagious and potentially dangerous to those who come into close contact with him.

By the way, experts say this about the possibilities of safe intimate relationships: during the period of exacerbation, it is desirable to refuse sex because even a condom will not protect a partner from infection. The fact is that the herpes virus can be found not only on the genitals, but also on other areas of the skin that look quite healthy and “lull vigilance”.

Oral sex is especially dangerous with a person who has a cold on his lips. However, another situation is also possible: if one partner has a virus that affects the genitals, then the other has a risk of infecting the lips during oral sex. There is nothing surprising in this, because both the lips and the genitals are affected by the same viruses - HSV-1 and HSV-2.

We talked about how to quickly treat herpes on the lip in the article.

Psychosomatics

The popular point of view that supposedly most diseases "come from the nerves" in the case of herpes takes on a concrete meaning. Not only did the insidious virus find shelter in the spinal ganglia (nerve nodes), it is also responsible for the occurrence of severe internal human suffering.

Here is a typical example. My husband has secondary (recurrent) herpes, which makes intimate relationships impossible. But, as soon as the man recovers, herpes appears in his wife - such is the unexpected reaction of a man who for a long time wanted closeness, but was afraid of getting infected, for whom both kiss and hugs were forbidden.

Psychosomatics also explains the reasons for the so-called “post-trip” illness: the husband spends a lot of time traveling, and when he finally ends up at home, his wife, who has long dreamed of meeting, has rashes on her genitals.

In order not to live in fear that this will happen again and again, and you can’t get rid of problems on your own, you should definitely consult a doctor.

Incubation period

The incubation period in patients with genital herpes for the first time is not a constant value: sometimes it can be 1 day, a week, sometimes (and this is the maximum period) - 26 days. However most often this period is 2 - 10 days.

Symptoms and signs: how it manifests itself

Quite often, the disease is asymptomatic, it is possible to do without rashes and without blisters. If the virus is strong and active, you have to observe the following manifestations of the disease:

muscle pain in the hips, lower back, pelvic area;
feeling of general weakness, malaise;
headache;
frequent urination with unpleasant tingling sensations;
between the legs there is a burning sensation, itching, the skin itches;
lymph nodes increase in the groin;
on the mucous membranes of the genital organs and on the skin appear first - redness, and then - vesicles.

Men are characterized by swelling of the glans penis, pain during intercourse, for women - inflammation of the lymph nodes on the pubic part, severe itching (including in the anus area).

In rare cases, patients may develop a fever.

Further symptoms are as follows: the vesicles open, and weeping ulcers appear in their place, which quickly heal with crusts. After the crusts fall off, traces of them may remain on the skin.

Symptoms, treatment and photos of herpes on the head in men are collected in the article. You will find information on the treatment of herpes on the labia.

What does genital herpes look like (photo)

Types and stages

By the nature of the onset and development of the disease There are 4 types of genital herpes:

in the first case (meaning primary infection), the sick person had no contact with the carrier of the virus before, antibodies were not produced in his blood, infection occurs for the first time;
in the second case (secondary infection), herpes is already present in the body, there are also antibodies, but infection with the genital virus occurs for the first time;
the third type - recurrent (typical or atypical), is associated with the activation of a genital virus already present in the body;
the fourth type is asymptomatic.

There is also a classification based on duration of symptoms. The disease can proceed:

arrhythmic - remission and exacerbation succeed each other at various time intervals, from 20 days to six months;
monotonously - the intervals between remission and exacerbation are almost the same, usually 3-4 months;
fading - the length of the remission period is getting longer, and the active symptoms are fading away.

The disease in its development goes through a number of stages. They can be distinguished by their symptoms:

redness, rash, burning appear (this happens within 3-4 days);
rashes, merging, are transformed into bubbles filled with liquid contents - first transparent, and then darkening (5-7 days);
bubbles burst, sores are formed that can bleed, burning sensations are replaced by painful sensations (3-7 days), if the disease is neglected, then new bubbles will appear in place of unhealed wounds and the disease will stretch for a long time (up to 2-3 months) term;
ulcers will be covered with crusts, which will fall off on their own, it is not recommended to tear them off, otherwise scars may form in their place (the healing process lasts 5-10 days).

What can be confused with

The complexity of diagnosis is due to the fact that the virus affects each person differently: if its opponent is weak, the symptoms are pronounced, if it is strong, the signs may be fuzzy or absent altogether.

Most questions arise when other infections join genital herpes- fungal, bacterial, viral, in this case it is difficult to identify the true culprit of troubles without laboratory tests.

What can be confused with genital herpes? A person who does not have a medical education will first of all suspect the most unpleasant thing - a venereal disease. Doctors will see similarities with diseases such as:

thrush;
colds;
haemorrhoids;
allergic reaction;
food poisoning;
syphilis.

Diagnostics

When the disease is in the "bubble" stage, the doctor can easily make a diagnosis as a result of a visual examination of the patient. What to do if there are no characteristic external signs yet? Pass the analysis and laboratory examination of biological samples for the presence of antibodies in the body - check blood, study genetic material for DNA viruses. If the studies give a negative answer, it means that the patient's condition has not worsened due to genital herpes and research should be continued to find the true culprit of the troubles.

Methods of particularly accurate diagnostics include:

PCR - polymerase chain reaction method(helps to identify pieces of DNA of the virus);
ELISA - enzyme immunoassay(based on the fact that the body remembers how it has already fought a similar disease, therefore it will give a clear answer about whether the patient is infected or not, even in the absence of a relapse).

This video will also tell about diagnostic methods:

How long does it take

If we exclude the danger of any complications, then genital herpes disappears, even without treatment, in two weeks in men and in three in women. A competent treatment regimen, a well-chosen medicine make it possible to reduce the most unpleasant period for the patient (with vesicles and sores) to five days.

It must also be borne in mind that Treatment times are very individual., and no antiviral drugs can completely cure the disease: the herpes that enters the body will remain in it forever, and the disease will become chronic - fortunately, asymptomatic in most cases.

Which doctor treats this disease

Usually treated at home, without hospitalization. But certainly - with medical participation.
To whom to turn with such an intimate problem? Representatives of the stronger sex - to the urologist, women - to the gynecologist. Both those and others, if necessary, can be assisted by a dermatovenereologist. Consultations with an immunologist will also not interfere, since the causes of the activation of the herpes virus are always closely related to the weakening of the immune defense of the human body.

Treatment of genital herpes in men and women

The main objectives of treatment are to alleviate the patient's condition, stop the spread of infection and strengthen the body's immune response to a dangerous virus.

Folk remedies

As an independent treatment, folk remedies cannot be used, but as an addition to the medicines prescribed by the doctor, it is desirable. Genital herpes can help:

lavender and geranium oil diluted in water, - for the preparation of lotions;
tea tree oil- in the early stages of the disease;
propolis - to treat rashes to prevent the spread of infection;
apple cider vinegar - to wipe the rash, before the formation of sores;
decoction of birch buds- for lotions;
aloe juice - as a bactericidal agent.

Baths with an infusion of medicinal herbs are also useful, and for oral administration - puree from products of a “general restorative effect” - fresh apples, onions, honey.

Preparations

Effective treatment is achieved through the use of various pharmaceutical agents - antiviral, antipruritic, immuno-strengthening. In situations where the underlying disease is accompanied by other infections and the patient's condition is severe, the doctor prescribes antibiotics.

Acyclovir;
Famciclovir (compared to Aciclovir, it has a higher absorption rate, so the recommended dosage may be lower);
Valacyclovir (sometimes used simultaneously with Acyclovir);
Zovirax (not only tablets, but also cream);
Cycloferon (having the properties of an antiviral drug and an immunomodulator).

Besides, the doctor, depending on the problem he is solving, can prescribe:

An ideal remedy would, of course, be a vaccination against genital herpes, but, unfortunately, it is not yet available. The Herpevac vaccine is under development and pharmacists expect it to be an effective protection for people who are sexually active. So far, it has been possible to reduce the risk of infection by up to 75 percent, and the drug has a better effect on the female body than on the male.

Diet and proper nutrition

The task of the anti-herpes diet is to give the body the strength to strengthen the immune system, fight infection. It is not recommended to drink alcohol, coffee, strong tea. You should limit yourself to flour, sweet foods (chocolate, sugar, raisins), do not eat peanuts.

Useful for genital herpes: dairy and seafood, fruits that contain vitamins, lean meat (for example, chicken). Methods of cooking dishes - steamed, in a slow cooker (in stewing and baking modes). Drinking should be plentiful.

Suppressive therapy

This branch of medicine provides methods that minimize the number of relapses in a patient. The doctor develops a special course of treatment, and quite a long one. Sometimes it involves taking antiviral pills for a year.

Suppressive therapy is used in relation to patients in whom the exacerbation of the disease is an exhausting reality that does not give long respite.

Through this therapy:

improves the quality of life of the patient;
the development of his disease is controlled;
reduces the risk of infecting others.

The best result is the complete destruction of the virus, but this happens extremely rarely and only with the prompt (within 24 hours after infection) use of antiviral drugs - during this time the virus does not yet have time to go into a latent state.

How to cure a disease in children

The well-known pediatrician Yevgeny Komarovsky is sure that it is almost impossible to protect a child from the virus, it is transmitted from parents who, for example, had a cold on their lips. A child who falls ill after mom and dad will easily transfer the infection from the face to other parts of the body. According to the famous pediatrician, you can help the baby by strengthening his immunity, hardening, not wrapping, encouraging him to play sports.

If the child gets sick (and children suffer from genital herpes more severely than adults), you should definitely seek medical help. The doctor will select medications that are appropriate for both the age and condition of the young patient, and may prescribe injections. Among the drugs that are prescribed to children: Acyclovir, Groprinosin, Gerpevir, Zovirax, Arpetol, Neovir. They help get rid of itching: Claritin, Cetrin, Fenistal. At a temperature exceeding 38.5 degrees, they begin to give antipyretic drugs.

Relapse and exacerbation of the disease

Relapses occur more frequently in women than in men. Also, according to medical statistics, they depend on the socio-economic status of the person: the lower it is, the higher the likelihood of reactivation of the viral infection. As for age, here risk zone - 30-40 years. And a direct impetus to relapse can be stress, hypothermia, overwhelming mental and physical stress.

It is important to remember that in 20-30 percent of cases, complications are possible that pose a threat to the joints, nervous system, and pelvic organs.

What is dangerous: consequences and complications

The consequences of the disease (especially if the recovery occurred without medical supervision) are:

dry skin and mucous membranes on the genitals;
the development of various bacterial infections;
the spread of the papilloma virus;
persistent neurosis, depression;
aching pains that capture the lower abdomen, perineum;
diseases of the genitourinary system (cystitis, urethritis).

For women, the consequences of a poorly treated disease are especially dangerous, there is a threat of infertility, cancer.

Prevention

The best means of prevention is this type of relationship when no promiscuous intimate relationships and unprotected contacts. If this still happens, genital hygiene is necessary (especially during the first one and a half to two hours after a possible infection), as well as vaccination to develop immunity.

By the way, you can take care of immunity in other ways - go in for sports, harden the body, eat a balanced diet.

For many years, genital herpes remained out of the attention of practitioners of public health, which was primarily due to insufficient laboratory diagnostics of herpes infection, underestimation of the role of herpes simplex virus (HSV) in human infectious pathology, as well as the lack of effective methods of treatment.

ICD-10 code

B00 Herpes simplex infections

Epidemiology of genital herpes

Herpes is a common human viral infection and is a serious medical and social problem. In the early 70s of the last century in the USA and European countries, there was a sharp increase in the incidence of genital herpes, which by the 80s had increased 10-fold and amounted to 80 in England and France, and 178 cases per 100 thousand people in the USA . According to WHO, diseases transmitted by the herpes virus rank second (15.8%) after influenza (35.8%) as the cause of death from viral infections.

It is now established that about 90% of the urban population in all countries of the world is infected with one or more types of herpes virus. Clinical manifestations of infection have 20% of them. Recurrent herpes infections are observed in 9-12% of the inhabitants of different countries. The highest incidence of genital herpes is recorded in the age group of 20-29 years and 35-40 years.

Causes of genital herpes

Genital herpes is caused by two serotypes of the herpes simplex virus: herpes simplex virus type (HSV-1) usually causes oral-labial herpes, herpes simplex virus type 2 (HSV-2) often causes genital lesions. Possessing neurodermotropism, HSV affects the skin and mucous membranes, the central nervous system, and the eyes. HSV causes the pathology of pregnancy and childbirth, often leads to "spontaneous" abortions and fetal death. After infection, the virus is latent in a locally located sensitive ganglion and periodically reactivates, causing symptomatic lesions, or there is an asymptomatic, but no less infectious shedding of the virus. Infection with any of these viruses can cause an identical first episode of illness. However, the rate of subsequent relapses is higher with HSV-2 infection than with HSV-1 infection.

Infection occurs by contact, usually by skin-to-skin contact. The incubation period is from 2 to 12 days (average 6 days).

Considering that during the incubation period and during the recurrence of the disease there is a high contagiousness, it is necessary to refrain from sexual intercourse at this time. The risk of transmission is higher from male to female. Primary HSV infection reduces the risk of HSV-2 seroconversion in serodiscordant couples. Genital herpes is more common in women and in blacks than in whites. Genital infection caused by HSV-1 recurs much less frequently than with genital localization of the focus of infection caused by HSV-2, which is 95% of the total number of patients with recurrent genital herpes (RGH). HSV is characterized by neurotropism (a tendency to inhabit nerve cells).

The main links in the pathogenesis of herpetic infection are:

infection of the sensory ganglia of the autonomic nervous system and lifelong persistence of HSV;
HSV tropism for epithelial and nerve cells, which determines the polymorphism of the clinical manifestations of herpes infection.

Under certain conditions, HSV multiplies in the T- and B-lymphocytes of the patient.

In recent years, it has been established that HSV also persists in the epidermocytes of the skin, mucous membranes and secretions. Various clinical manifestations, the severity of the course of infection are explained by the peculiarities of local and general immunity.

Symptoms of genital herpes

50-70% of patients infected with the herpes simplex virus do not complain or complain of meager pain, burning. In the clinical course of HSV, it is customary to distinguish between primary and recurrent herpes.

Primary herpes is an acute disease that occurs at the first contact of a person with HSV against the background of the absence of specific antibodies against it.

Primary genital herpes occurs predominantly in women in the form of vulvovaginitis, but the cervix may also be involved in the process. Primary herpetic vulvovaginitis is characterized by the appearance of pronounced edema and hyperemia of the labia majora and labia minora, vaginal mucosa, perineum and, often, the inner thighs. There is pain, itching and dysuria, discharge from the vagina or urethra.

In men, the primary elements are often localized on the head, body of the penis, neck of the head, scrotum, thighs and buttocks. Grouped bubbles appear, first with transparent, and then cloudy contents. After the opening of the bubbles, extensive weeping erosions are formed, which have a round shape. Merging, they form extensive ulcers with a weeping surface. Epithelial defects heal in 2-4 weeks, leaving behind hyperpigmented spots. There are usually no scars.

When the urethral mucosa is affected, frequent urination appears and sometimes cystitis develops. With an atypical course, vesicles may be absent, and hyperemia develops in the area of the foreskin, burning, itching are observed. In severe cases, erosive and ulcerative lesions, skin edema, severe intoxication, and fever occur. Frequent relapses lead to lymphostasis and elephantiasis of the genital organs.

Such prodromal phenomena in recurrent genital herpes as burning or tingling precede the appearance of rashes. With recurrent genital herpes, the elements of the rash are the same as with primary herpes, but less pronounced. A hyperemic plaque 2 cm in diameter is covered with vesicles. After opening, erosions are formed, which heal in 1-2 weeks. In case of recurrence, the elements of the lesion are located in men on the body and glans penis, in women - on the large and small labia, in the perineum and on the inner surface of the thighs. Regional lymph nodes in the second or third week become enlarged, dense, painful, there is no fluctuation, the lesion is usually unilateral. With the defeat of the lymph nodes of the pelvis, pain appears in the lower abdomen. The disease is often accompanied by headache, fever, malaise and myalgia. In atypical forms of genital herpes, any one of the stages of the development of the inflammatory process in the focus (erythema, blistering) or one of the components of inflammation (edema, hemorrhage, necrosis), or subjective symptoms (itching), which give the appropriate name to the atypical form, predominates genital herpes (erythematous, bullous, hemorrhagic, necrotic, itchy, etc.).

In women, atypical forms are more common than in men. In most patients, genital herpes proceeds atypically and is accompanied by signs that can easily be mistaken for signs of other genital infections or dermatoses.

The course of genital herpes

According to the course of recurrent genital herpes, 3 degrees of severity are distinguished:

mild - exacerbations 3-4 times a year, remissions for at least 4 months;
medium-severe - exacerbations 4-6 times a year, remissions - 2 3 months;
severe - monthly exacerbations.

Reactivation of the virus after primary infection within a year occurs in 50-80% of patients. Antiviral drugs only reduce the titer of the virus that the patient releases into the environment, and 100-1000 times reduce the risk of infection transmission.

Histopathology

Pathological changes are the same as with simple vesicular lichen.

Treatment of genital herpes

Antiviral therapy should be used in all cases of diagnosis of genital herpes. Its goals are to alleviate the severity of the symptoms of the disease, prevent complications and relapses.

Sexual partners of patients with herpetic infection of the urogenital tract are subject to active identification. Treatment should be carried out with clinical manifestations of herpes. It should be advised to abstain from sexual activity or use condoms during exacerbations.

Treatment for a primary episode of genital herpes is with acyclovir, valaciclovir, or famciclovir.

In the primary episode of genital herpes, acyclovir (ulcaril, herpsevir, etc.) is used at 400 mg 3 times a day or 200 mg orally 5 times a day for 7-10 days (in the USA) or 5 days (in Europe). This reduces the duration of virus isolation and clinical manifestations. In addition, acyclovir may affect the course of neurological complications such as aseptic meningitis and urinary retention.

In practice, proteflasite is widely used, which has an antiviral, immunocorrective effect. The drug is prescribed 15-20 drops 2 times a day. The effectiveness of therapy increases with the application of proteflasite to the lesions.

In severe cases, accompanied by neurological complications, acyclovir is administered intravenously at a dose of 5-10 mg/kg 3 times a day. A comparative study of the use of a high oral dose of acyclovir (4 g/day) and a standard dose (1 g/day) for the treatment of genital herpes infection did not reveal any clinical benefit of a higher dose.

In the US, valaciclovir is approved for the treatment of a primary episode of genital herpes at a dose of 1000 mg twice daily for 7-10 days.

The use of 250 mg famciclovir 3 times a day for 5-10 days is as effective in the primary episode of genital herpes as the use of acyclovir.

During relapses of the disease, acyclovir is administered orally at 400 mg 3 times a day or 200 mg 5 times a day for 5 days. Although this treatment leads to a reduction in the duration of virus shedding and the manifestation of symptoms of individual episodes, it does not remove the interval between relapses.

Famciclovir is used as an episodic treatment of recurrent genital herpes at a dose of 125 mg orally 2 times a day for 5 days.

Preventive treatment of genital herpes

Prophylactic (preventive, suppressive) treatment of genital herpes consists in the use of acyclovir, valaciclovir or famciclovir in a long-term continuous regimen. Such treatment is indicated for patients with an exacerbation frequency of 6 episodes per year.

Daily intake of 400 mg of acyclovir orally 2 times a day prevents the development of recurrences of genital herpes. With this use, the frequency of exacerbations is reduced by 80%, and in 25-30% of patients during the entire period of taking acyclovir they do not occur at all.

Famiiclovir is also effective in suppressing recurrent genital herpes at a dose of 250 mg orally 2 times a day.

External treatment is the same as for simple vesicular lichen.

Genital herpes refers to diseases caused by a virus from a large group of herpes. To date, there are 8 types of such diseases, some of which have not been fully studied. The special secretive nature of the infection, when the virus in the body can not manifest itself for years without causing harm to health, and then suddenly go into an open phase, has long been a mystery to medical science and practice. In 1988, pharmacological researcher Gertrude Elion even received the Nobel Prize for developing a herpes treatment. Problems with recognizing diseases of this group lie in the fact that infection with a virus can lead to the appearance of symptoms of genital herpes, and may not affect human health in any way, existing secretly. The development of a form of the disease with lesions of the genital organs may be due to the first and second types of the herpes virus.

The first type of herpes, the so-called herpes simplex, or HSV, is commonly known as the proverbial "cold on the lips." Most modern people become infected with it already in childhood through saliva or close contact (for example, kissing, skin contact). You can be a carrier of HSV for many years, not suspecting it, until, under certain conditions, itching, burning, blisters around the lips or on the oral mucosa suddenly appear. Less common localization on the face near the eyes, nose, neck. A person feels the manifestations of a feverish state, and may not have any other problems, except for unpleasant rashes on the face. After a few days, the lesions dry out, turning into a crust. Painful manifestations disappear by themselves, and the virus "hides" until the next episode.

By itself, HSV does not pose a serious threat to humans. When localized on the lips, it usually comes down to discomfort and an unaesthetic appearance. It is impossible to cure the disease (at least at the current level of development of medicine). But there are drugs that relieve symptoms, reduce the duration of discomfort and the affected area.

Problems with HSV occur in the following cases:

localization in the eyes can be harmful to vision;
with immunodeficiency (for example, with HIV), herpes can begin to develop uncontrollably, leading to damage to the brain and other organs.

Herpes of the first type is more often localized on the face, but if you have oral sex in the presence of signs of an exacerbation of the disease, then the infection can be easily transferred to the genitals.

The second type of virus is sexually transmitted, that is, it refers to STDs. It mainly affects the area of the external genitalia. Herpes of the second type can also appear on the face, but this is much less common. The external manifestations of this virus will be the same as those of the first type (itching, burning, blisters, crust).

Ways of infection

It is important to distinguish between sources of infection.

HSV type 1 is transmitted by contact, it can occur through any skin contact or fluid exchange. But the cause of the genital form of herpes when infected with the first type of virus will be oral intercourse with the transfer of the virus to the genitals.

With the second type of virus, the main route of infection is sexual intercourse. Contact transfer in this form of the disease has not been proven. The lesion will be localized in the genital area, but can rarely occur elsewhere. Infection is possible when the skin comes into contact with an open sore. Infection of a child can occur when it passes through the birth canal of the mother, which sometimes leads to very significant problems with the health and development of the baby.

Risk factors

The risk of infection with the genital herpes virus (that is, the second type virus) is very high for any person who is sexually active.

This is due to the fact that a significant part of the population is infected. According to some studies, up to half of the adults in the world are infected. But many of them never had episodes of exacerbation of genital herpes in their lives. And therefore - do not suspect that they are its hidden carriers. With all the desire to completely remove the virus from the body, it is impossible, a person will be a carrier for life.

The “push” for the first or next outbreak of blisters on the genitals may be the following conditions:

hypothermia or overheating;
temporary decrease in immunity after diseases;
stress;
immunodeficiency states;
overwork.

Genital herpes: symptoms of the disease

The first clinical episode of the disease has nothing to do with the time of infection: it can occur a few days after infection or decades later.

A person infected with the virus sometimes remains a latent carrier, never encountering clinical manifestations of genital herpes (that is, rashes in the genital area). He will find out about it only after passing special tests, or he will remain in the dark forever, but will infect his sexual partners.

If the first episode has occurred, then the disease can become recurrent, that is, the rashes will recur if any of the factors that suppress the immune system occur. The ability of the body to recognize the virus and suppress its reproduction does not depend on the timing or method of infection.

There is no cure for recurrent genital herpes. We can only talk about reducing the number and frequency of episodes, the affected area, reducing and preventing negative health effects.

Stages of herpetic eruptions

First, harbingers of the disease appear: itching, burning and swelling in the genital area. In this case, there may be pulling pains in the perineum, aching in the hips, passing into the lower back. A person may experience symptoms of a feverish condition (fever, chills).

The next stage is characterized by redness in the genital area and perineum, hyperemia.

Then bubbles appear, both separately located and merging into the whole affected area. Some of them turn into erosion, sores with separated transparent contents.

In general, the lesions of genital herpes look the same as the "cold on the lips", only localization differs.

Clinical manifestations of genital herpes

Medicine considers genital herpes as a special case of infection with a virus of the first or second type.

With a recurrent variant of the disease, the severity of the manifestation of genital herpes is distinguished, taking into account, first of all, the frequency of episodes:

mild form (up to 3 cases of clinical manifestations of signs of exacerbated genital herpes over the past 12 months, the acute phase may not be every year);
moderate severity (4-6 episodes per year);
severe form (more than 6 phases of acute manifestation, when the body does not have time to recover between episodes).

Also, in the study of the clinical picture, localization is taken into account. The course of the disease is aggravated by rashes in an atypical place (for example, at the entrance to the anus), as well as concomitant diseases (combinations with HIV or other forms of herpes infections, such as cytomegalovirus).

Particular attention is required for the diagnosis and treatment of genital herpes in people who want to become parents.

Atypical forms of genital herpes

In medical practice, cases of atypical course of the disease are described. With this variant of genital herpes, itching and burning in the genital area or anus, reddening of the zones, even papules (seals) periodically occur, but bubbles of a characteristic type do not form. Cracks may appear on the skin or mucous membranes, which then heal on their own.

With an atypical form, an external examination is not enough for diagnosis. A person may not suspect herpes for a long time, because he does not see bubbles. In such cases, it is possible to verify the presence of the disease only on the basis of laboratory diagnostics.

Genital herpes in newborns

If the immunity of an adult, as a rule, copes with the task of suppressing the virus, then for newborns, with their still unsettled system for responding to infections, genital herpes poses a serious threat. Therefore, when preparing for the birth of children, one of the items on the list of things to do is to get tested for genital herpes in both parents.

Babies can become infected directly at the time of birth, passing through the birth canal of an infected mother. In such a situation, their immune system is completely unprepared to meet the virus, the disease can develop very quickly, leading to infection of internal organs with serious consequences - inflammation of the genitourinary system or brain. With the first option, further infertility is possible, with the second - the threat of developmental delay, pathologies and even death of the baby.

In addition, genital herpes in newborns and young children can cause a number of pathologies:

impaired functioning of the organs of vision and hearing;
problems with the cardiovascular system;
fusion of the girl's penis;
malfunction of the nervous system;
oncology of the genital organs;
pathology of the gastrointestinal tract;
secondary infection with other diseases due to a violation of the integrity of the skin and a decrease in immunity.

Also, newborns can get the genital herpes virus in the following ways:

during perinatal development, if the mother's body is very weakened and produces few antibodies, not protecting the fetus;
vertically during a relapse in the mother, when herpes from the genitals enters the amniotic fluid;
when feeding and close bodily contact with a person who has an exacerbation of the disease;
when kissing (type 1).

The lower the age of the baby at the time the genital herpes virus enters the body, the more dangerous the consequences are possible. In addition, small children still cannot control themselves, therefore, due to itching, they will comb and injure the affected area, worsening the situation.

In children, the disease easily acquires a relapsing character with further episodes 10-15 times a year, which depletes the child and leads to intoxication of the body.

In children, genital herpes manifests itself not only as rashes (which can be all over the body), but also as an increase in inguinal lymph nodes, fever, vomiting, and pain. At the first suspicion of herpes, it is urgent to show the child to the doctor and start treatment.

Diagnosis of genital herpes

In the acute course of the disease, the very appearance of the patient with characteristic vesicles on the genitals (or in another area of the body) already suggests that the problem is associated with herpes. A number of specialists can give a referral for tests - a urologist, gynecologist, proctologist, dermatovenereologist.

With the latent nature of the disease or an atypical form, the presence of an infection in the body can be reliably recognized only during laboratory diagnostics.

The highest reliability is given by a smear analysis using the PCR diagnostic technique.

Analyzes must be passed even without signs of illness to partners when planning conception, pregnant women, preferably when entering into a new relationship, so as not to spread the infection.

Treatment of genital herpes

Since it is impossible to completely cure herpes, the goals of therapy are:

episode prevention and reduction;
reducing the severity of symptoms and discomfort during an exacerbation;
reduction of negative consequences for the body;
minimizing the risk of transmission of infection, including infection of the fetus or newborn when planning a pregnancy.

Even if it is reliably known (according to test results) that a person is infected, but there are no episodes of the acute phase of herpes, then treatment is not carried out, since the body copes with the virus on its own. Such a person will be advised to closely monitor the maintenance of his immunity and avoid factors that provoke an exacerbation of the disease.

In the first acute episode or recurrent form, the treatment regimen includes the following components:

suppression of infection (antiviral agents);
increase immunity and body defenses;
local external agents (ointments for genital herpes).

One of the key agents in the fight against the virus are acyclovir and its analogues, valaciclovir and famciclovir. But a qualified doctor should choose the treatment regimen, dose and method of administration of the drug (intravenously, tablets, ointments), taking into account the characteristics of the patient's body, the course of the disease and related problems.

At the time of treatment, it is necessary to give up sexual activity.

In some cases, hospitalization is indicated in the venereal department of hospitals:

with acute urinary retention;
with a particularly dangerous (disseminated) form of genital herpes, which occurs in patients with immunodeficiencies (HIV, chemotherapy, organ transplantation, serious illnesses);
with damage to the central nervous system.

The treatment regimen for genital herpes in men and women is similar in most cases.

Genital herpes during pregnancy

It is especially important to control the situation in preparation for pregnancy and in the process of bearing.

Since infection of the fetus or newborn can be fatal, both potential parents, in preparation for conception, need to determine their status, that is, find out whether they are carriers of the infection or not.

If it is known that the expectant mother has already been infected with the herpes virus, then she needs to take measures under the supervision of a doctor to maintain immunity, which can be weakened in pregnant women. It is important to prevent an exacerbation of the disease during gestation, especially before the onset of childbirth. If this still happens, then it is necessary to consult a doctor in a timely manner. Effective regimens for the treatment of genital herpes during pregnancy exist. A qualified specialist will give recommendations to reduce the risk of infection of the fetus.

If the expectant mother is not infected, then she needs to take measures to prevent infection with the virus (do not have unprotected sex, maintain hygiene, minimize close bodily contact with strangers).

Prevention of genital herpes

Primary prevention of genital herpes is associated with a reduced risk of contracting it. To do this, it is necessary to adhere to a culture of safe sex (reduce the number of sexual partners, use high-quality latex condoms correctly).

When infected with herpes, prevention implies constant maintenance of the body's defenses and minimization of factors provoking relapses (do not overcool, do not overheat, take immunomodulators when recovering from diseases, reduce the number of stress factors, adhere to a healthy lifestyle and rest in time).

With the initial manifestation and relapses, you should not engage in uncontrolled administration of drugs. The decision on how to treat genital herpes, in each case, should be made by a qualified doctor.

Genital herpes refers to infections transmitted by contact. Doctors distinguish between primary and recurrent herpes, which is divided into typical and atypical varieties and may be asymptomatic. Genital herpes is common in the population of all countries.

What is genital herpes

With typical herpes, there is always a lesion on the skin and mucous membranes of the external genital organs. Localization of the genital rash is first observed on the external genitalia in the perineum.

In people with strong immune systems, the disease is often asymptomatic. Infection is detected using data from a virological examination, in which pathogenic agents obtained from a smear are isolated.

Atypical forms of herpes are detected in the treatment of chronic inflammation in the pelvic organs in women after diagnostic studies.

Primary genital herpes

Symptoms of herpes that develops in the genital area appear for the first time due to the weakening of the protective functions of the body. Bubble rashes caused by the herpes simplex virus are a place where pathogenic microflora breeds. Affected areas open the entrance of aggressive microflora to the lymph and blood.

In primary infection, the introduction of viruses into the nerve endings of the skin or mucous membrane occurs. Then the pathogens reach the sensitive ganglia of the central nervous system, where they remain until the end of the life of the infected, releasing scout cells that test the level of immunity.

Symptoms

Signs of the disease are determined by the traditional form of genital infection. Patients complain of severe itching and pain in the intimate area. On the genitals of men and women, multiple painful vesicles appear, tending to merge and transforming into pustular rashes. The appearance of a rash is accompanied by pain, itching, thickening of the lymph nodes in the genital area. After opening the papules, the wounds hurt when rubbed and urine gets on them.

A rash with relapses gradually affects the internal genital organs. This may reveal erosion of the cervix, causing severe pain during sexual intercourse.

A papular rash appears in the perineum and can spread throughout the genital area.

The virus often infects the lower urethra, causing severe pain when emptying the bladder. Herpetic vesicles can cover the mucous membrane of the anus and rectum, which complicates the process of defecation (more). Children and adults infected with the herpes virus often experience numbness in the skin of the perineum, difficulty urinating, and constipation.

Asymptomatic herpes will occur in people with a well-functioning immune system. The absence of problems in the genital area and the inflammatory process will continue as long as the body suppresses the pathogen.

What does genital herpes look like

Manifestations of genital herpes are difficult to confuse with other skin diseases. Specific rashes on the genitals in women directly indicate the development of a herpes infection.

Herpes, which affected the skin in the genital area, appears at the site of the primary infection. Before rashes on the mucous membranes and skin, severe itching appears, which is difficult to eliminate. Then red rounded spots appear, dense and slightly painful to the touch. Then, in the middle of the spot, several papules form, which tend to unite. Several small blisters or 1 large blister may form.

When the skin on the rash bursts from an excess of infected fluid, weeping ulcers form, which ooze for about 5 days if they are not treated with special means. After the formation of a dry crust, the regeneration process begins.

Stages of development

Symptoms of herpes appear, gradually increasing, which makes it possible to distinguish between the stages of the disease. Genital infection lasts for 3 weeks or more and is characterized by:

first, a feverish state at a low temperature;
itching and burning in the intimate area;
swelling of the affected area;
pain in the groin;
skin rashes;
the formation of bubbles;
rupture of papules;
the occurrence of a weeping ulcer;
scab formation.

Herpes on the genitals develops according to one scenario, but at the beginning it can be stopped.

Causes

The causes of infection are sought in the weakening of the immune system, the ability of the pathogenic agent to resist interferons and adapt to the environment. Herpes is caused by 2 types of the Herpes simplex virus.

Type 1 virus most commonly affects the lips and is called herpes labialis. With a sharp weakening of immunity, the herpes simplex virus type 1 can cause a primary skin lesion on the genitals. Herpes type 2 only affects the genitals. If an exacerbation of the disease occurs several times a year or is chronic, then HSV-2 is to blame.

A secondary exacerbation in the genital area is caused by a weakening of the immune defense due to a sharp change in ambient temperature, physical or mental trauma, alcohol intake, and a change in the hormonal cycle.

How is genital herpes transmitted?

Type 2 genital herpes is transmitted by airborne, contact, transfusion routes. They can be contracted during organ transplants. During pregnancy, there is a risk of infection of the fetus by a transplacental or transcervical route.

Primary infection most often occurs by airborne droplets at an early age.

The source of infection is relatives suffering from an acute form of herpetic infection.

In adulthood, vaginal contact with a virus carrier leads to infection and the development of a primary infection if the immune system was weakened during intimacy.

If there was oral contact, then the rash will affect the throat, causing symptoms of pharyngitis. In the future, the presence of a virus in the body will reduce immunity, and a genital infection will manifest itself.

Treatment

The genital herpes virus can be learned to be controlled with a specially prescribed course of treatment. Pharmacists offer drugs that can stimulate the immune system or replace its insufficiency with active interferons.

Diagnostics

Doctors use a variety of diagnostic methods. An initial examination of the affected area makes it possible to make a preliminary diagnosis. The results of laboratory tests allow you to see an accurate picture of the disease. The presence of antibodies to HSV type 2 in the blood gives reason to the attending physician to prescribe treatment.

You can undergo a virological study, in which the contents of the vials are placed on special cell media so that the virus multiplies. This allows you to determine the type of pathogenic agent.

Gene diagnostics allows you to identify the DNA of the virus in the secretions taken for analysis from a sick person.

Prevention

To prevent recurrences of herpes spreading in the genital area, you need to lead a healthy lifestyle. In the cold season, it is recommended to take care of the state of immunity, strengthening it with herbal preparations. Good nutrition and hardening contribute to stable remission.

Genital herpes and pregnancy

The disease can interfere with conception. To prevent complications during gestation, pregnancy should be planned and a medical examination should be carried out before conception.

If a herpesvirus is detected in a woman's blood, the patient will undergo treatment that will suppress the pathogenic agent for the entire period of gestation. If there is no relapse during childbirth, then the baby can be born healthy, although there is always a risk of infection penetrating the placental barrier.

What is dangerous genital herpes

The consequences of genital herpes are dangerous for people of all ages. Constant relapses depress the immune system, which leads to a decrease in the quality of life and the appearance of various diseases. The nervous system suffers greatly, a person with a genital rash often experiences depression.

The development of relapses can give complications to the internal genital organs, which leads to infertility. Exacerbation during pregnancy infects the fetus and causes spontaneous abortion.

People with short periods of remission are at risk of getting leukoplakia. In this disease, the epithelium lining the inner cavity of the bladder turns into a stratum corneum. The walls of the organ lose their elasticity, which leads to dysfunction of the urinary tract.

Genital herpes. How to get rid of itchy perineum

Genital herpes and its treatment.

GENITAL HERPES. Myth and reality

Herpes genital (genital) is a common disease that is transmitted from person to person sexually and is accompanied by pain in the genital area. In this case, characteristic rashes in the form of bubbles appear. The causative agent of genital herpes is HSV (herpes simplex virus) type 2.

Diagnosis of genital herpes

The basis for the diagnosis of genital herpes is a microbiological study. To do this, a drop of liquid is taken from the bubbles, placed in a special medium and grown for 1-2 days. Herpes simplex virus type 1 (HSV1) most often occurs on the skin, lips, chin, nose, and eyes, while HSV 2 affects the genital mucosa, the skin around them, and the skin around the thighs and buttocks.

In this case, genital herpes can also develop with a mixed infection of both types of herpes simplex. We recommend that you read the material about.

How is genital herpes transmitted?

There are several ways that the genital herpes virus can be transmitted from person to person.

Namely:

sexual
domestic
inoculation
vertical

The sexual route of transmission of the genital herpes virus is the main one. It is carried out with any type of sexual contact (genital, oral, anal). Only sick people who have active manifestations of the disease can be carriers of the infection: vesicles, sores. When the sores dry up and the crusts fall off, the person with the virus is no longer contagious. There is a possibility of a domestic transmission of the genital herpes virus (for example, through common personal hygiene products), but it is unlikely, because when it enters the external environment, the secret (liquid from the bubbles) dries quickly, ceasing to be contagious. The inoculation route of transmission of HSV is one in which the patient infects himself by inadvertent transfer from the main focus (for example, from the skin of the face) to other parts of the body (for example, to the mucous membrane of the genitals or eyes). The vertical route of transmission of the genital herpes virus is one of the most dangerous. It is transmitted from a pregnant woman to the fetus (intrauterine or during childbirth) and is the most dangerous because it causes miscarriages, fetal malformations. Congenital genital herpes in children causes numerous disorders in the functioning of the nervous system and internal organs, in which newborns have little chance of surviving. It would not be superfluous to read an article about.

Therefore, genital herpes during pregnancy should be the subject of special attention of doctors.

Herpes genital: symptoms

In most cases (90%), there are no clinical symptoms of infection with genital herpes at all. The first active manifestations are most often the first manifestation of a chronic infection, so if they appeared, for example, immediately after sexual contact, it does not mean at all that this was due to this particular contact (it just became a provoking factor in the disease).

A provoking factor can be any factor that reduces immunity, such as: a stressful situation, SARS, hypothermia, overwork, menstruation in women, surgery, excessive alcohol consumption, and many others. The first noticeable symptoms of genital herpes are single and multiple elements of the rash, which always develop in the same way: inflammation, the appearance of a vesicle, rupture of the vesicle, the appearance of an ulcer, the appearance of a crust.

The period of rashes lasts no more than one to two weeks. You should know what genital herpes looks like so as not to confuse its manifestations with another disease. So, for example, if the rashes last longer, have a different development pattern (or do not change at all), then they probably have nothing to do with genital herpes.

Genital herpes in women

Women will develop a characteristic rash on the labia, in the area of the clitoris, on the pubis, on the thighs, buttocks, sacrum, in the area of the urethral kagal. With genital herpes in women, a rash on the vaginal mucosa or on the cervix is possible, but extremely rare. Also, symptoms characteristic of genital herpes are itching and pain in the area of the vesicles, discomfort during urination.

Sometimes there may be an increase in temperature and an increase in lymph nodes in the groin.

Genital herpes in men

The manifestation of genital herpes in men is generally the same as in women: herpetic eruptions are accompanied by tingling, pain, itching. The rash disappears in about a week, leaving brown spots on the skin. Herpes is localized in men on the penis (mucous membranes and foreskin), on the thighs, buttocks, in the anus, urethra.

Complications of genital herpes

Genital herpes must be treated. Otherwise, there is a risk of developing various complications, the main of which are:

long-term persistence of symptoms of genital herpes (up to several months)
neuropathy, dysuria and, as a consequence, acute urinary retention
cystitis
infertility (both men and women)
damage to internal organs, penetration into the brain (in immunodeficiency states)
in men: urethritis, herpetic prostatitis
in women: in combination with the papillomavirus, an increased risk of developing cervical cancer
psychological and psychosexual problems

All about genital herpes (video)

Genital herpes: treatment

Complete destruction of the virus in the treatment of genital herpes cannot be achieved. However, it is necessary to treat this disease in order to minimize the frequency of new manifestations. The main method of treatment of genital herpes, both in men and women, is the medicinal method (antiviral chemotherapy).