Herpes Simplex in Emergency Medicine Treatment & Management

  • Author: Rahul Sharma, MD, MBA, FACEP; Chief Editor: Steven C Dronen, MD, FAAEM   more...
 
Updated: Apr 27, 2011
 

Emergency Department Care

ED care consists of diagnosis and appropriate treatment. Most patients may be treated in the outpatient setting. Identification of patients that need inpatient treatment (ie, encephalitis) and initiation of antiviral and supportive therapy is imperative.

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Consultations

Ophthalmologist for keratoconjunctivitis

Obstetrician for active genital herpes in a near-term pregnancy

Outpatient dermatologist for differentiation of skin infections

Infectious disease specialist for disseminated disease and encephalitis

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Contributor Information and Disclosures
Author

Rahul Sharma, MD, MBA, FACEP  Assistant Professor, Weill Medical College of Cornell University; Assistant Director for Operations, Department of Emergency Medicine, New York Presbyterian Hospital-Weill Cornell Medical Center

Rahul Sharma, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Lawrence C Brilliant, MD  Clinical Assistant Professor, Department of Primary Care and Community Services, MCP Hahnemann University; Attending Physician, Department of Emergency Medicine, Doylestown Hospital

Lawrence C Brilliant, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Robin R Hemphill, MD, MPH  Associate Professor, Director, Quality and Safety, Department of Emergency Medicine, Emory University School of Medicine

Robin R Hemphill, MD, MPH is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Eric L Weiss, MD  DTM&H, Medical Director, Office of Service Continuity and Disaster Planning, Fellowship Director, Stanford University Medical Center Disaster Medicine Fellowship, Chairman, SUMC and LPCH Bioterrorism and Emergency Preparedness Task Force, Clinical Associate Professor, Department of Surgery (Emergency Medicine), Stanford University Medical Center

Eric L Weiss, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Occupational and Environmental Medicine, American Medical Association, American Society of Tropical Medicine and Hygiene, Physicians for Social Responsibility, Southeastern Surgical Congress, Southern Association for Oncology, Southern Clinical Neurological Society, and Wilderness Medical Society

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Steven C Dronen, MD, FAAEM  Chair, Department of Emergency Medicine, LeConte Medical Center

Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References

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  2. Biggs WS, Williams RM. Common gynecologic infections. Prim Care. Mar 2009;36(1):33-51, viii. [Medline].

  3. Tronstein E, Johnston C, Huang ML, Selke S, Magaret A, Warren T, et al. Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection. JAMA. Apr 13 2011;305(14):1441-9. [Medline].

  4. [Guideline] Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. Aug 4 2006;55:1-94. [Medline].

  5. Frenkl TL, Potts J. Sexually transmitted infections. Urol Clin North Am. Feb 2008;35(1):33-46; vi. [Medline].

  6. Pasternak B, Hviid A. Use of acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA. Aug 25 2010;304(8):859-66. [Medline].

  7. Johnson R. Herpes gladiatorum and other skin diseases. Clin Sports Med. Jul 2004;23(3):473-84, x. [Medline].

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  9. Clark JL, Tatum NO, Noble SL. Management of genital herpes. Am Fam Physician. Jan 1995;51(1):175-82, 187-8. [Medline].

  10. Cockerell C. Diagnosis and treatment of cutaneous herpes simplex virus infections. West J Med. Jun 1996;164(6):518-20. [Medline].

  11. Hill J, Roberts S. Herpes simplex virus in pregnancy: new concepts in prevention and management. Clin Perinatol. Sep 2005;32(3):657-70. [Medline].

  12. Hirsch MS. Herpes simplex virus. In: Mandell GL, ed. Mandell, Douglas, and Bennet's Principles and Practice of Infectious Diseases. 4th ed. Churchill Livingstone; 1995:1336-45.

  13. Holland-Hall C. Sexually transmitted infections: screening, syndromes, and symptoms. Prim Care. Jun 2006;33(2):433-54. [Medline].

  14. Patel R, Rompalo A. Managing patients with genital herpes and their sexual partners. Infect Dis Clin North Am. Jun 2005;19(2):427-38, x. [Medline].

  15. Rooney JF, Straus SE, Mannix ML. Oral acyclovir to suppress frequently recurrent herpes labialis. A double-blind, placebo-controlled trial. Ann Intern Med. Feb 15 1993;118(4):268-72. [Medline].

  16. Whitley RJ, Gnann JW Jr. Acyclovir: a decade later. N Engl J Med. Sep 10 1992;327(11):782-9. [Medline].

  17. Wu JJ, Pang KR, Huang DB. Advances in antiviral therapy. Dermatol Clin. Apr 2005;23(2):313-22. [Medline].

 
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Cutaneous vesicles characteristic of herpes simples virus infection
Herpes labialis
Penile infection with herpes simplex virus type 2
Tzanck smear showing a multinucleated giant cell
Herpes simplex virus dendritic ulcer with fluorescein staining.
Genital herpes infection
 
 
 
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