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Case 1: Herpes Simplex Virus Infection

Author: David H. Spach, MD

Case last updated: September 10, 2008

A 26-year-old HIV-infected man with a CD4 count of 14 cells/mm3 presents with a 5 week history of lesions on his ear (Figure 1 and Figure 2). He has not taken any medications for these lesions. For the past week, the lesions have become more painful. A diagnosis of herpes simplex virus infection (HSV) is eventually made.

Which of the following is TRUE regarding HSV infections in HIV-infected persons?

A When performing a fluorescent antibody (FA) and culture for HSV, scraping the base of the lesion will provide a higher yield than obtaining exudative fluid.
B The most appropriate therapy for this lesion would be valganciclovir (Valcyte) 900 mg PO bid x 4 weeks.
C The diagnosis of chronic (longer than 4 weeks) ulcerative herpes simplex is an AIDS-defining condition, regardless of CD4 cell count.
D Answers A and C are correct.
  • The following link will open in a new window.
    Figure 1 - Chronic Ulcerated Lesions on Ear Figure 1
  • The following link will open in a new window.
    Figure 2 - Chronic Ulcerated Lesions on Ear Figure 2