Corey L, Adams H G, Brown Z A, Holmes K K
Ann Intern Med. 1983 Jun;98(6):958-72. doi: 10.7326/0003-4819-98-6-958.
The clinical course and complications of 268 patients with first episodes and 362 with recurrent episodes of genital herpes infection were reviewed. Symptoms of genital herpes were more severe in women than in men. Primary first-episode genital herpes was accompanied by systemic symptoms (67%), local pain and itching (98%), dysuria (63%), and tender adenopathy (80%). Patients presented with several bilaterally distributed postular ulcerative lesions that lasted a mean of 19.0 days. Herpes simplex virus was isolated from the urethra, cervix, and pharynx of 82%, 88%, and 13% of women with first-episode primary genital herpes, and the urethra and pharynx of 28% and 7% of men. Complications included aseptic meningitis (8%), sacral autonomic nervous system dysfunction (2%), development of extragenital lesions (20%), and secondary yeast infections (11%). Recurrent episodes were characterized by small vesicular or ulcerative unilaterally distributed lesions that lasted a mean of 10.1 days. Systemic symptoms were uncommon and 25% of recurrent episodes were asymptomatic. The major concerns of patients were the frequency of recurrences and fear of transmitting infection to partners or infants.
回顾了268例初发性生殖器疱疹感染患者和362例复发性生殖器疱疹感染患者的临床病程及并发症。女性生殖器疱疹症状比男性更严重。原发性初发性生殖器疱疹伴有全身症状（67%）、局部疼痛和瘙痒（98%）、排尿困难（63%）及触痛性淋巴结病（80%）。患者出现多个双侧分布的丘疹性溃疡性损害，平均持续19.0天。82%的初发性原发性生殖器疱疹女性患者的尿道、88%的宫颈及13%的咽部可分离出单纯疱疹病毒，28%的男性患者尿道及7%的咽部可分离出该病毒。并发症包括无菌性脑膜炎（8%）、骶自主神经系统功能障碍（2%）、生殖器外损害的发生（20%）及继发性酵母菌感染（11%）。复发性发作的特点是单侧分布的小水疱或溃疡性损害，平均持续10.1天。全身症状不常见，25%的复发性发作无症状。患者主要关心的是复发频率以及害怕将感染传播给性伴侣或婴儿。
