Answer

Ulcers

Genital Herpes

(Herpes Simplex Virus 2)

An 28 year old graduate student comes into the family practice clinic complaining of fever, inguinal adenopathy, and painful vesicular lesions on her genitalia. Physical exam reveals similar lesions on her anal area. She admits to being sexually active.

Laboratory: Isolation of an enveloped, linear dsDNA virus from the lesion by cell culture. Tzanck smear shows multinucleated giant cells with intranuclear inclusions.

Discussion: The diagnosis of genital herpes by Herpes Simplex Virus 2 (HSV-2) is made by both clinical presentation and labs. HSV-2 is transmitted by sexual contact. The number of infections by HSV-2 is on the rise. HSV-I is usually associated with infections "above the waist", while HSV-2 is associated with infections below the waist. HSV-2 is also assocated with cervical cancer.

For more information on Herpes Simplex Virus 2, click here.