A male client is diagnosed with herpes simplex. Which statement about herpes simplex infection is true?
A. During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature delivery.
B. Genital herpes simplex lesions are painless, fluid-filled vesicles that ulcerate and heal in 3 to 7 days.
C. Herpetic keratoconjunctivitis usually is bilateral and causes systemic symptoms.
D. A client with genital herpes lesions can have sexual contact but must use a condom.
Correct Answer: A. During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature delivery.
Herpes simplex may be passed to the fetus transplacentally and, during early pregnancy, may cause spontaneous abortion or premature delivery. Both primary and recurrent HSV infections in pregnant women can lead to intrauterine transmission and resultant congenital HSV infection. More women than men have been reported to be infected, and as expected, the prevalence increases with an increasing number of sexual partners.
Option B: Genital herpes simplex lesions typically are painful, fluid-filled vesicles that ulcerate and heal within 1 to 2 weeks. Genital symptoms are commonly seen in the outpatient primary care setting, despite many going without a clear diagnosis. HSV-2, in particular, may present as a primary infection with painful genital ulcers, sores, crusts, tender lymphadenopathy, and dysuria.
Option C: Herpetic keratoconjunctivitis usually is unilateral and causes localized symptoms, such as conjunctivitis. It is commonly subclinical, and the only manifestation may be mild, self-limiting blepharoconjunctivitis, marked by inflammatory vesicles or ulcers and can include lesions in the corneal epithelium. Mild fever, malaise, or upper respiratory tract infection may also be present.
Option D: A client with genital herpes lesions should avoid all sexual contact to prevent spreading the disease. There is no cure for HSV-2, early identification of symptoms, and prompt institution of pharmacotherapy can lead to early suppression of viral replication. Abstinence during known viral shedding can decrease the risk of transmission to a seronegative partner.
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