DRG Category: 606

Mean LOS: 5.9 days

Description MEDICAL: Minor Skin Disorders with Major CC

classification section:



There are two types of herpes simplex virus (HSV), type 1 and type 2. HSV-1 causes infection above the waist, such as "cold sores" that occur on the mouth. This type may occur in the genital area as a result of oral–genital sexual practices. After the initial infection, the virus is dormant, but the patient is a carrier and likely to have recurrent infections. Events that trigger recurrences are sun exposure, fever, menses, stress, and lack of sleep.

HSV-2 causes lesions in the genital area. In the primary episode, multiple, blisterlike, painful vesicles erupt on the vulva, perineum, cervix, tip or shaft of the penis, or perianal area within 3 to 5 days after the initial exposure. The virus then becomes dormant and resides in the nerve ganglia of the affected area. Repeated outbreaks can happen at any time, but most patients have less severe regular recurrences that are more likely to occur during menses, pregnancy, or times of illness and stress. The more severe the primary outbreak, the more frequent the recurring infections. In the United States, 22% of the adult population has HSV-2, and 1.7 million new cases are diagnosed each year.

Active HSV is associated with spontaneous abortion in the first trimester of pregnancy and an increased risk of preterm labor after 20 weeks' gestation. If a patient has active herpes around the time of the estimated date of delivery, cesarean section is the preferred method of delivery. Infected infants can develop the following signs and symptoms after an incubation period of 2 to 12 days: fever, hypothermia, jaundice, seizures, poor feeding, and vesicular skin lesions.