valacyclovir and Sexually-Transmitted-Diseases

Sexually transmitted diseases (STDs) continue to be a global epidemic with significant risk of morbidity/mortality for the fetus. STDs with prominent cutaneous findings including condylomata acuminata, genital herpes infections, and syphilis are reviewed. Important clinical cutaneous findings help aid early diagnosis and facilitate treatment. Condylomata acuminata have the potential of causing cervical cancer, anogenital cancer, and oropharyngeal cancer. Significant advances have been made in human papilloma virus vaccinations and treatment. Genital herpes infection can produce significant physical and emotional distress to the patient and significant potential harm to the fetus. Early clinical recognition of STDs and their appropriate management is critical.

Topics: Acyclovir; Aminoquinolines; Anti-Bacterial Agents; Antineoplastic Agents; Antiviral Agents; Chancre; Condylomata Acuminata; Female; Herpes Genitalis; Humans; Imiquimod; Papillomavirus Infections; Papillomavirus Vaccines; Penicillins; Podophyllotoxin; Sexually Transmitted Diseases; Syphilis, Cutaneous; Uterine Cervical Neoplasms; Valacyclovir; Valine

A man in his late 30s presented with a several-day history of rectal pain, discharge and bleeding associated with systemic upset. Sexual history revealed receptive anal sex with several male partners in the 2 weeks preceding his clinic visit. Examination of the perianal area was unremarkable. Proctoscopy showed evidence of non-ulcerative proctitis. Microscopy for Gram stain showed pus cells plus extracellular Gram-negative diplococci. The patient was treated for presumptive gonorrhoea and chlamydial infection with ceftriaxone, azithromycin and doxycycline. The patient failed to improve with this treatment regimen. Rectal swab results at 48 hours confirmed the causative agent to be herpes simplex virus (HSV) type 2. The patient was recalled and treated successfully with valaciclovir. This case serves as a useful reminder to clinicians to consider HSV in the differential diagnosis of sexually transmitted proctitis, in the absence of perianal or anorectal ulceration.

Topics: Adult; Antiviral Agents; Diagnosis, Differential; DNA, Viral; Gonorrhea; Herpes Simplex; Herpesvirus 2, Human; Humans; Inflammatory Bowel Diseases; Intestinal Mucosa; Male; Proctitis; Rectum; Sexual Behavior; Sexually Transmitted Diseases; Valacyclovir