OBSTETRICS AND GYNECOLOGYTREATMENT
■ Metronidazole 2 g PO ×one dose or 500 mg PO BID ×7 days
■ Partners should also be treated.
HERPES SIMPLEX VIRUS (HSV)SYMPTOMS/EXAM
■ Painful, fluid-filled vesicles that progress to shallow-based ulcers
■ Dysuria and pelvic pain may occur.
■ May also see systemic symptoms of fever, malaise, headache, and
myalgias
DIAGNOSIS
Genital herpes is diagnosed based on clinical examination. If necessary, con-
firm with culture or PCR of fluid obtained from vesicle.
TREATMENT
■ Treat with antiviral agents, usually acyclovir or famcyclovir, within one
day of symptom onset.
■ Treatment shortens duration of symptoms but is not curative and does not
affect the frequency or severity of recurrences.
FIGURE 12.5. Trichomonads under high-power view.
(Reproduced, with permission, from Tintinalli JE, Kelen GD, Stapczynski JS. Emergency
Medicine: A Comprehensive Study Guide, 6th ed. New York: McGraw-Hill, 2004:694.)