Herpes simplex vegetans: Atypical genital herpes infection in a patient with common variable immunodeficiency

About that time I noticed what looked to be an infected hair follicle on the middle of my scrotum. i was in a relationship with a woman, and had unprotected sex with her many times. Fungal and acid-alcohol resistant bacilli screening were negative. His CD4 cell count improved in the years 2002–2006 and subsequently in late 2006 he had a decline in CD4 to 140. He mentioned Herpes as a possible cause and advised me to come back if I got a rash or sores etc. The diagnosis was further confirmed by the onset of postherpetic neuralgia of the thigh 5 weeks after the lesions first appeared.

3   Correct. In April 2009, his absolute CD4 count was 3 cells/μL and HIV viral load was 488,000 RNA copies/mL. [1] In our patient he gave past history of herpes and he was improving with acyclovir previously. Final Advice. The first case dates from 1979, when Wahba et al. He was switched to boosted indinavir-containing second line HAART regimen in late 2006.

My peeing went weird, and I had bladder pain. The patient specifically denied any antecedent sexually transmitted disease or systemic illness, and further asserted that he had been celibate for years. Most patients have minimal symptoms from an infection, but these generally include blisters in the genital area which can take two to four weeks to heal after the initial outbreak. One immediately was flat, the other was raised. Recently, the detection and subtyping of HSV from CSF on the LightCycler platform have been validated for clinical use (3). So, based on your comment in this thread, is it okay to conclude that if there haven’t been any lesions/sores/ulcers but incredible pain it’s due to something other than herpes?


Genital herpes infection is common in the United States. The immunostaining for the HSV was performed on a semiautomated immunostainer from Ventana Inc using a streptavidin–biotin–peroxidase approach and for CMV on a Labvision 720 semiautomated immunostainer from Thermo Scientific using UltraVision LP polymer system. The most common vaginal infection three women are bacterial vaginosis, candidiasis and trichomoniasis (also known as candidiasis). Two hundred microliters of the antimicrobic solution was added to the 750-μl aliquot of specimen, and the mixture was centrifuged for 10 min at 2,300 rpm (900 × g). The majority were linked to known sequence variations in the probe binding site (3a, 7). Other aspects of your symptoms also are inconsistent with herpes.

1) Sure, your partner could be infected without symptoms. The sample size was 60 cases all with genital lesions such as ulcers and vesicles were selected. Characteristically early opening of the vesicles with the formation of erosive surfaces, pronounced subjective symptoms (pain, itching, burning in the hearth). They examined me, and gave me doxycycline for 7 days, plus valtrex for 7 days. It is considered an acquired immune deficiency syndrome defining disease in a previously diagnosed HIV (human immune deficiency syndrome) patient. To further complicate matters, the risk of human immunodeficiency virus-1 (HIV-1) acquisition is three fold higher among herpes simplex virus-2 (HSV-2) sero-positive persons [7].

3. Histopathological examination revealed epidermal necrosis, without evidence of viral inclusions, vasculitis, or atypical cell proliferation. It is important to recognize the clinical presentation as well as the distinct histological appearance of this rare benign entity. Epidermolysis Bullosa: Clinical, Epidemiologic, and Laboratory Advances, and the findings of the National Epidermolysis Bullosa Registry. Persistent EM, however, is a rare variant, with few cases reported in the literature. The last two were very minor- the first one was two small sores, and the one last week was just one and went away in less than two days.

The description of my situation is quite lengthy, and I apologize, but I want to be as thorough as possible. Your message has been sent. So I ask what could an atypical outbreak look or feel like? This may be followed by pain on passing urine and an outbreak of herpes sores or blisters on or around the genitals. 2 HSV Curriculum 2 Learning Objectives 1.Describe the epidemiology of genital HSV in the U.S. Hey Doctor, so I think of myself as a herpes hypocondriac, because i am constantly living in fear of it..

Herpes infections are ubiquitous.