Virus
Herpes Simplex Virus
Herpes simplex virus commonly causes recurrent infection affecting the skin, mouth, lips, eyes and genitals. Common severe infections include encephalitis, meningitis, neonatal herpes, and disseminate infection (in immuno-compromised patients). Mucocutaneous infections cause clusters of small painful vesicles on an erythematous base. Disgnosis is clinical, laboratory confirmation by culture, PCR, direct immunofluorescence, or serologic testing can be done. Treatment is symptomatic, antiviral therapy is helpful for severe infections and, if begun early, for recuurent and primary infections.
Virus
Genital Herpes
This is the most ulcerative sexually transmitted disease in developed countries. It is also becoming a common place even in developing countries. It is usually caused by HSV-2, although 10% - 30% of cases involve HSV-1. Primary lessions develop 4 to 7 days after contact. The vesicles usually erode to form ulcers that may coalesce. Lessions may occur on the prepuce, glans penis and penile shaft in men, and on the labia, clitoris, perineum, vagina and cervix in women. They may occur arround the anus and in the rectum in men and women who engage in receptive rectal intercourse. Genital HSV infection may cause urinary hesitancy, dysuria, urinary retention or constipation. Severe sacral neuralgia may occur. Scarring may follow healing and recurrences occur in 80% of patients with HSV-2 and in 50% with HSV-1. Primary genital lessions are usually more painful, prolonged, and widespread and are more likely to be bilateral and involve regional adenopathy and constitutional symptoms than recurrent genital lessions. Recurrent lesions may have severe prodromal symptoms and may involve the buttocks, groin, or thigh.
Bacteria
Bacterial Vaginosis and Candida Albican (Thrush)
Bacterial Vaginosis is an offensive vaginal discharge with fishy odour. Vaginal pH is >5.5. The vagina is not inflammed and pruritus is uncommon. There is increased risk of preterm labout and intraaminiotic infectin in pregnancy. Diagnosis is by culture. Treatment can be prescribed by Dr. Anonymous. Candida Albican (Thrush) is the commonest cause of vaginal discharge which is classically white curds. The vulva and vagina may be red, fissured and sore, especially if there is allergic component. Pregnancy, contraceptives and other steroids immunodeficiencies, antibiotics and diabetes are risk factors. Diagnosis is by microscopy which reveals strings of mycelium or typical oval spores culture. Treatment can be prescribed by Dr. Anonymous.
