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Genital Herpes Simplex Virus Infections: Clinical Manifestations, Course, and Complications

LAWRENCE COREY, M.D.; HARRY G. ADAMS, M.D.; ZANE A. BROWN, M.D.; and KING K. HOLMES, M.D., Ph.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Lawrence Corey, M.D.; Division of Virology, Children's Orthopedic Hospital Medical Center, P.O. Box C5371, 4800 Sand Point Way, Seattle, WA 98105.


Seattle, Washington


© 1983 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1983;98(6):958-972. doi:10.7326/0003-4819-98-6-958
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The clinical course and complications of 268 patients with first episodes and 362 with recurrent episodes of genital herpes infection were reviewed. Symptoms of genital herpes were more severe in women than in men. Primary first-episode genital herpes was accompanied by systemic symptoms (67%), local pain and itching (98%), dysuria (63%), and tender adenopathy (80%). Patients presented with several bilaterally distributed postularulcerative lesions that lasted a mean of 19.0 days. Herpes simplex virus was isolated from the urethra, cervix, and pharynx of 82%, 88%, and 13% of women with first-episode primary genital herpes, and the urethra and pharynx of 28% and 7% of men. Complications included aseptic meningitis (8%), sacral autonomic nervous system dysfunction (2%), development of extragenital lesions (20%), and secondary yeast infections (11%). Recurrent episodes were characterized by small vesicular or ulcerative unilaterally distributed lesions that lasted a mean of 10.1 days. Systemic symptoms were uncommon and 25% of recurrent episodes were asymptomatic. The major concerns of patients were the frequency of recurrences and fear of transmitting infection to partners or infants.

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