Resistant herpes simplex type 2 treated with varicella zoster vaccination

A 27-year-old British male presented with a 1-day history of balanoposthitis and penile discharge. He disclosed multiple, unprotected male partners over preceding months. He had no significant medical history, no history of herpes simplex virus (HSV) and no previous STI screen. Examination revealed extensive ulceration and swelling of the prepuce, with purulent discharge. He was treated for gonorrhoea, identified on microscopy. Empirical treatment for HSV was also commenced (aciclovir for 10 days). A sexual health screen detected gonorrhoea, HSV-2 and new HIV infection (CD4 150 cells/μL (9%), viral load 124 777 copies/mL). After 1 week, the ulceration had spread to the perianal area. It appeared clinically to have secondary infection. He was commenced on antiretroviral therapy and antibiotics. Further courses of oral aciclovir were prescribed (escalating doses up to a maximum of 800 mg, five times per day) with limited benefit. Several wound cultures were taken which grew variable organisms. However, antibiotics and...
Source: Sexually Transmitted Infections - Category: Sexual Medicine Authors: Tags: Miscellaneous Source Type: research