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Herpes Simplex

Herpes Simplex is a topic covered in the 5-Minute Emergency Consult.

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  • Viral disease characterized by recurrent painful vesicular lesions of mucocutaneous areas
  • Lips, genitalia, rectum, hands, and eyes most commonly involved
  • Infection is characterized by 2 phases:
    • Primary, in which virus becomes established in a nerve ganglion;
    • Secondary, involves recurrence of disease at the same site
  • Incubation period is ∼4 days from exposure
  • Viral shedding occurs from 7–10 days (up to 23 days) in primary infection and 3–4 days in recurrent infections
  • Neonatal infections can occur in utero, intrapartum (most common), or postnatal
    • Occur in 1/3,500 births per year in the US
  • Human-to-human transmission
  • 60–90% of population is infected with herpes simplex type 1 (HSV-1) or type 2 (HSV-2)
  • More common in blacks than whites in ages <40 yr
  • Females affected more than males


  • HSV-1 or HSV-2 are DNA viruses of the Herpesviridae family
  • Viral transmission may occur via respiratory droplets, contact with mucosa or abraded skin with infected secretions:
    • Recurrent mucosal shedding of HSV may transmit the virus
    • Rate of recurrence varies with virus type and anatomic site
  • Both viruses infect oral or genital mucosa:
    • Most common for HSV-1 to cause oral infections and HSV-2 to cause genital infections

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Rosen, Peter, et al., editors. "Herpes Simplex." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307098/all/Herpes_Simplex.
Herpes Simplex. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307098/all/Herpes_Simplex. Accessed April 23, 2019.
Herpes Simplex. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307098/all/Herpes_Simplex
Herpes Simplex [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307098/all/Herpes_Simplex.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Herpes Simplex ID - 307098 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307098/all/Herpes_Simplex PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -