Genital herpes
Genital herpes (HSV) — diagnostics, antiviral therapy, and recurrence management.
What is genital herpes?
Genital herpes is a viral sexually transmitted infection caused by Herpes Simplex Virus (HSV). HSV-2 is the most common cause, but HSV-1 (oral herpes) increasingly causes genital infections.
Symptoms of genital herpes
- Primary outbreak: Painful vesicles (blisters) on genitals, fever, swollen inguinal lymph nodes, painful urination
- Recurrent outbreaks: Milder symptoms, prodromal signs (itching, burning, tingling before blisters appear)
- Atypical symptoms: Fissures, ulcerations without classical vesicles
Herpes diagnostics
- PCR test — most sensitive method, HSV DNA detection from lesion
- Direct lesion swab — sampling from active blister
- Serology (IgG, IgM) — blood test for HSV-1 vs HSV-2 typing
- Tzanck test — cytological finding of multinucleated giant cells
Treatment and management
- Antiviral therapy — acyclovir, valacyclovir (shortens outbreak duration)
- Suppressive therapy — daily low dose for recurrence prevention
- Local care — keeping lesions clean and dry
Herpes in pregnancy
Genital herpes in pregnancy requires special monitoring. Primary outbreak in the third trimester may indicate cesarean delivery to prevent neonatal herpes.
Written by
Dr Slobodanka Petković
Specialist in Gynaecology & Obstetrics · 35+ years of experience
Patients often ask
Herpes simplex virus cannot be fully eliminated, but is effectively controlled with antiviral therapy.
Herpes is most contagious during active outbreaks (blisters). Transmission is also possible during asymptomatic phases (viral shedding).