Prevention and Treatment

Avoidance of sexual intercourse during active symptoms and the use of condoms with a spermicide reduce but do not eliminate the chance of transmission. Spermicidal jellies and creams can inactivate herpes simplex viruses. There is no cure for genital herpes, although medications such as acyclovir and famciclovir

Human Penis Infections

Figure 25.18 Genital Warts on the Penis, a Manifestation of Human Papillomavirus Infection

Chapter 25 Genitourinary Infections

Table 25.13 Genital Herpes Simplex

Symptoms

Itching, burning pain at the site of infection, painful urination, tiny blisters with underlying redness.The blisters break, leaving a painful superficial ulcer, which heals without scarring. Recurrences common

Incubation period

Usually 1 week (range, 2 to 20 days)

Causative agent

Usually herpes simplex virus, type 2.The cold sore virus, herpes simplex type 1, can also be responsible. Herpesviruses are enveloped and contain double-stranded DNA

Pathogenesis

Lysis of infected epithelial cells results in fluid-filled blisters containing infectious virions. Rupture of these vesicles causes a painful ulceration.The acute infection is controlled by body defenses; genome persists within nerve cells in a non-infectious form beyond the reach of body defenses. Replication of infectious virions can occur and cause recurrent symptoms in the area supplied by the nerve. Newborn infants can contract fatal generalized herpetic infection if their mother has a primary infection at the time of delivery.

Epidemiology

No animal reservoirs.Transmission by sexual intercourse, oral-genital contact.Transmission risk greatest first few days of active disease.Transmission can occur in the absence of symptoms. Herpes simplex increases the risk of contracting AIDS

Prevention and treatment

Abstinence, monogamy, and condoms help prevent transmission. Medications help prevent recurrences, shorten duration of symptoms. No cure

Figure 25.18 Genital Warts on the Penis, a Manifestation of Human Papillomavirus Infection can decrease the severity of the first attack and the incidence of recurrences.

The main features of genital herpes simplex are presented in table 25.13.

Papillomavirus STDs: Genital Warts and Cervical Cancer

Sexually transmitted human papillomaviruses (HPV) are among the most common of the sexually transmitted disease agents, infecting an estimated 40 million Americans. Although they cannot be cultivated in the laboratory, their presence in human tissues can be studied by using nucleic acid probes. Some of them are responsible for papillomas, warty growths, of the external and internal gentalia; others cause non-warty lesions of mucosal surfaces such as the uterine cervix and are a major factor in the development of cervical cancer. Invasive cervical cancer strikes about 12,500 Americans each year and kills more than 4,500 of them. ■ nucleic acid probes, pp. 225,236

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