According to "Harrison's Principles of Internal Medicine," herpes simplex viruses produce a variety of infections involving the mouth and face, genitals, eyes, nervous system and internal organs. The exact symptoms and course of herpes depend on the anatomic site involved, the age and health status of the patient and the specific virus causing the infection . Some symptoms are more common than others.
Prodrome
According to a 2008 article in the "Archives of Internal Medicine," 60 percent of people experience early or premonitory symptoms of herpes called a prodrome. The prodrome of herpes includes symptoms such as tingling, itching, burning, soreness or extreme sensitivity on the parts of the body where lesions later develop. In some people, these symptoms are accompanied by subtle swelling or redness.
Flu-Like Illness
According to a 2005 article in the journal "American Family Physician," 80 percent of people with herpes report a flu-like illness that begins on or around the time that lesions appears. Symptoms often include fever, headache, muscle or joint pain, malaise and lack of appetite and may last anywhere from three to 14 days. Characteristic respiratory symptoms of flu-like cough and sore throat-are absent. Symptoms are usually most severe during the primary infection and become less severe in subsequent episodes, if they recur at all.
Sores
The single most common symptom of herpes, according to the article in the "Archives of Internal Medicine" is sores. However, advises the American Social Health Association, herpes sores are commonly mistaken for pimples, bug bites, abrasions, rashes and other kinds of skin problems. Herpes sores can develop on the skin or mucous membranes. They classically appear as a painful, 1 to 2 mm blister filled with clear or slightly cloudy yellow-tinged fluid. If you look closely, you may be able to distinguish a central depression or "umbilication."
Lesions can occur in clusters or alone. In some cases, multiple small blisters may coalesce into a single large blister. After 3 or 4 days, blisters usually rupture spontaneously, leaving behind a crumbly yellow scab or a shallow ulcer with clearly defined borders (punched-out lesion). Recurrent lesions usually heal in about a week. Lesions associated with the first outbreak take longer--sometimes up to 4 weeks.
References
- Herpes Simplex Viruses (Chapter); L. Corey; In: "Harrison's Principles of Internal Medicine, 17th edition;" A.S. Fauci, E. Braunwald, D.L. Kasper, S.L. Hauser, D.L. Longer, J.L. Jameson and J. Loscalzo (Eds.); 2008
- "Archives of Internal Medicine;" The Treatment of Herpes Simples: An Evidence-Based Review; C. Cernik, K. Gallina, and R.T. Brodell; 2008
- "American Family Physician;" Genital Herpes: A Review; J.G. Beauman; 2005
