Page 33 - Demo

26 MOGS Chronicles | Volume 1 | Issue 1 | September 2024IntroductionHerpes simplex virus (HSV-1) infection has been commonly detected cause of genital herpes in oral genital sex practice. Several studies have shown that the relative proportion of genital HSV-1 isolates has increased even more strikingly in past two decades due to increase in oral- genital contact.[1]Genital HSV-1, which almost always causes a true primary infection, is more likely to be severe during the initial episode. However, genital HSV-1 causes fewer recurrences (few or none after the 1st year of infection) and is shed asymptomatically infrequently.[2]Case ReportA 50 years old post- menopausal lady (menopausal since 2 years) had complaints of burning sensation in vagina after micturition, vaginal discharge accompanied by low grade fever, weakness, throbbing headache, flu like symptoms since 2 days. She had a history of international travel where she had sexual contact with partner 10 days ago. Her partner had past history of cold sores on his lips around 10 years ago.Currently he was asymptomatic. She was consuming micro and macro nutrient supplements but stopped since 1 month.On per speculum examination, cervix looked congested. There was minimal non-foul smelling white discharge and multiple ulcerative lesions around urinary meatus just inside labia minora and in anterior vaginal wall [Figure 1].Human immunodeficiency virus (HIV), venereal disease research laboratory (VDRL) and liquid based cytology (LBC) Pap smear with human papillomavirus (HPV) DNA and for genital tract infections namely HSV 1/2, trichomonas vaginalis, ureaplasma urealitycum, mycoplasma genitalium, N. gonorrhoeae and chlamydia trachomatis was done. The lab reports showed positive for HSV-1 virus. The rest all were negative. Her male partner underwent blood tests for all sexually transmitted infections (STI), HIV, VDRL. His HSV-1 immunoglobulin G (IgG) was positive, HSV-1 IgM negative. All other blood reports were negative. Her LBC Pap report showed inflammatory smear with no cytopathic changes of HSV in the cells of cervix, negative for intraepithelial lesion or malignancy. HPV negative. The patient%u2019s HSV-1 IgM and IgG were negative. She was given Tab Valacyclovir (500 mg) twice daily for 10 days along with multivitamin multimineral tablets and local gel to apply on the lesions. Her ulcerative lesions improved remarkably in 10 days and she became asymptomatic soon. Reference from a Dermatologist taken for her and partner. The Dermatologist prescribed Tab Valacyclovir (500 mg) twice daily for 3 months for her male partner. She was given a maintainance dose of tab Valacyclovir (500 mg) OD for 10 more days.DiscussionHSV-1 can be found in body fluids, enter the body through mucous membranes or skin abrasions. The first outbreak appears as blisters in vagina in 2%u201312 days after having sexual contact with someone who has or had HSV-1 infection in the past, particularly when immunity is low.The blisters may become ulcerative and ooze fluid. The viral infection may cause headache, bodyache and fever.Antiviral drugs taken at the first sign speed up the healing of sores and help to reduce the symptoms. However, it is important to know that HSV can be passed to another person even when symptoms are absent. To reduce the chances of transmitting HSV to a partner, use barrier Herpes simplex virus (HSV-1) affects 3.7 billion people under the age 50 years across the world as per World Health Organisation in 2016. HSV-1 most often causes infection in mouth and lips, called cold sores. It is highly contagious and can spread to genital area during oral sex and by genital touching. Genital herpes is more common in women than men. It is mainly because the mucosal lining of the female external genitalia is likely to be more vulnerable than the thin but keratinised skin of male genitalia. One in five women between ages 14%u201350 years has genital herpes. The first signs of genital herpes usually show up in 2%u201312 days after having sexual contact with someone who has herpes. It is a treatable sexually transmitted infections (STI), but the virus stays inside the body and becomes active from time to time. So genital herpes is a life-long disease. People should practice protected sex and undergo screenings for STI.Keywords: Genital herpes, Herpes simplex virus-1 infection, Sexually transmitted infectionGenital Herpes by Herpes Simplex Virus 1 in a Postmenopausal Woman: A Case ReportNeena PatwardhanDepartment of Obstetrics and Gynecology, Bhatia Hospital, Tardeo Road, Grant Road West, Mumbai 400 007, Mumbai, Maharashtra, IndiaCase ReportAbstractAddress for correspondence: Neena Patwardhan, Department of Obstetrics and Gynecology, Bhatia Hospital, Tardeo Road, Grant Road West, Mumbai 400 007, Mumbai, Maharashtra, India. Mobile: +91-9820482136. E-mail: drneenapatwardhan@gmail.com