Which physical findings are characteristic of genital herpes simplex virus (HSV) infections?

Updated: Feb 27, 2019
  • Author: J Michael Klatte, MD; Chief Editor: Russell W Steele, MD  more...
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The rash of primary genital herpes initially appears as macular and papular lesions, followed by a distribution of vesicles, blisters and pustules, with eventual rupture and formation of ulcers. Fever and localized inguinal adenopathy are frequently noted. Lesions are typically observed on labia majora, labia minora, and mons pubis in females and on the shaft of the penis in males. [68, 26]

The painful and tender lesions are associated with dysuria and may involve the buttocks, perineum, and vagina. Urinary retention is observed in 10-15% of female patients.

As many as 25% of women with genital herpes simplex virus have findings suggestive of meningitis.

Symptomatic recurrent herpes simplex virus infection can cause ulcerating vesicular lesions to appear (which are typically few in number and localized), or may manifest as merely irritation of the vulva in women. [18]

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