07-19-2006, 06:12 AM
A 37-year-old man comes to the clinic because of painful ulcers on his penis. He has no other symptoms, but he is very concerned because he recently returned from a business trip where he had sexual intercourse with a prostitute and he "obviously" does not want his wife to find out. He "needs" you to do something for him "fast". He admits to having other sexually transmitted diseases including chlamydia and gonorrhea before he was married. He denies ever having "sores" on his penis or anus in the past. Physical examination shows painful, shallow ulcers on the penis and the perineum. A Tzanck preparation made from a scraping taken from the base of the lesion shows multinucleated giant cells. The results of a tissue culture, which return 5 days later, show herpes simplex virus-2. You prescribe a 10-day course of oral acyclovir. He should be told that:
A. Chronic daily suppressive therapy with acyclovir does not reduce the frequency of reactivation
B. He needs to use condoms with his wife only when lesions are present
C. Herpes simplex virus-2 usually becomes a life-long latent infection in the epithelial cells
D. The recurrence rates for herpes simplex virus-1 are higher than that of herpes simplex virus-2
E. Vaccination against the hepatitis B virus is recommended at this time
A. Chronic daily suppressive therapy with acyclovir does not reduce the frequency of reactivation
B. He needs to use condoms with his wife only when lesions are present
C. Herpes simplex virus-2 usually becomes a life-long latent infection in the epithelial cells
D. The recurrence rates for herpes simplex virus-1 are higher than that of herpes simplex virus-2
E. Vaccination against the hepatitis B virus is recommended at this time