Atypical presentation of herpes simplex virus 2 primary infection: a case report.

Autor: Herbin C; Department of Gynaecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200, Brussels, Belgium. camille.herbin@student.uclouvain.be., Jadoul P; Department of Gynaecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200, Brussels, Belgium.; Gynaecology Research Unit, Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain, Av. Mounier 52, 1200, Brussels, Belgium., Hosten E; Emergency Medicine Department, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium., Gerday A; Department of Gynaecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200, Brussels, Belgium.; Gynaecology Research Unit, Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain, Av. Mounier 52, 1200, Brussels, Belgium., Luyckx M; Department of Gynaecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200, Brussels, Belgium.; Gynaecology Research Unit, Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain, Av. Mounier 52, 1200, Brussels, Belgium.; TILS Group - de Duve Institute, Université Catholique de Louvain, 1200, Brussels, Belgium., Squifflet JL; Department of Gynaecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200, Brussels, Belgium.; Gynaecology Research Unit, Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain, Av. Mounier 52, 1200, Brussels, Belgium., Perlepe V; Department of Radiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium., Maillard C; Department of Gynaecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200, Brussels, Belgium.; TILS Group - de Duve Institute, Université Catholique de Louvain, 1200, Brussels, Belgium.
Jazyk: angličtina
Zdroj: Journal of medical case reports [J Med Case Rep] 2024 Aug 25; Vol. 18 (1), pp. 393. Date of Electronic Publication: 2024 Aug 25.
DOI: 10.1186/s13256-024-04721-x
Abstrakt: Background: Cervicitis, an infectious or noninfectious inflammation of the cervix, encompasses a wide range of clinical conditions, from asymptomatic infections to severe lesions, making its diagnosis difficult. Acute cervicitis may develop into pelvic inflammatory disease. In patients with cervicitis, current guidelines recommend testing for herpes simplex virus when external genital lesions are present. Here, we present the case of a patient with an atypical primary herpes simplex virus 2 infection manifesting as cervicitis without genital lesions.
Case Presentation: A 29-year-old Caucasian woman was hospitalized for pelvic inflammatory disease. The patient complained of severe suprapubic pain, fever, and heavy vaginal discharge. The external genitalia were unremarkable, so empirical antibiotic treatment was initiated. Despite 48 hours of well-administered antibiotic therapy, her complaints persisted. Polymerase chain reaction for possible microbial causes was negative for Chlamydia trachomatis and Neisseria gonorrhoeae. There was no bacterial vaginosis. Repeat gynecological examinations with endovaginal ultrasound revealed an enlarged cervix, and pelvic magnetic resonance imaging supported a diagnosis of cervicitis. At this point, additional screening for other sexually transmitted infections and infectious disease-related etiologies of cervicitis was performed, and the polymerase chain reaction analysis of newly isolated samples was positive for herpes simplex virus 2. No antiviral treatment was initiated given the delay in diagnosing herpes simplex virus 2 infection and the slow but spontaneous abatement of symptoms.
Conclusion: Herpes simplex virus infection should be considered as a possible cause of cervicitis, even in the absence of typical genital lesions. Early detection of herpes simplex virus allows early treatment, helping to reduce the duration and severity of symptoms and therefore potentially reducing recurrences and improving disease control. These data and data from future cases might spur changes in the guidelines on cervicitis testing and treatment.
(© 2024. The Author(s).)
Databáze: MEDLINE
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