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Genital Herpes

September 3, 2026 · 17 min

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Ninja Nerds!

In this episode of the Ninja Nerd Podcast, Zach and Rob walk you through a high-yield, case-based approach to Genital Herpes, focusing on how to recognize primary versus recurrent disease, understand viral latency, and manage patients across a variety of clinical scenarios. This is one of the most common sexually transmitted infections, and the presentation can range from classic painful lesions to subtle or completely asymptomatic disease.

We start with the fundamentals of herpes simplex virus infection, breaking down the differences between HSV-1 and HSV-2, modes of transmission, and the pathophysiology behind latency and recurrent outbreaks. From there, we walk through classic patient presentations, including painful vesicular lesions, dysuria, tender lymphadenopathy, and systemic symptoms seen during primary infection.

Next, we focus on diagnosis and management, including when clinical diagnosis is enough, when confirmatory testing is needed, and how antiviral therapy with acyclovir, valacyclovir, and famciclovir is used for initial outbreaks, recurrent episodes, and chronic suppressive therapy. We also emphasize counseling points, asymptomatic viral shedding, and strategies to reduce transmission.

Finally, we cover high-yield complications and special scenarios, including neonatal herpes, immunocompromised patients, and management considerations during pregnancy to reduce the risk of neonatal transmission.

Let’s get into it, Ninja Nerds!

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