RESISTANT GENITAL HERPES IN A POSTMENOPAUSAL PATIENT

CASE REPORT

Abstract

Genital herpes is a sexually transmitted infection, with an incidence of 23.6 million people infected each year worldwide. In immunosuppressed hosts, it causes debilitating disease and may have sequelae in recurrent cases. A 70-year-old patient with a complaint and physical examination suggestive of genital herpes throughout the perineal, periclitorid region and buttocks, presenting lesions that had not responded with the use of acyclovir for 8 months, with no improvement with the use for three consecutive times. Five years ago, he presented non-Hodgkin’s lymphoma and was being treated with chemotherapy. Physical examination revealed vulvar ulcerated lesions and a local biopsy was performed. Magnetic resonance imaging showed no abnormalities. After unsuccessful treatment with corticosteroid and antibiotic therapy, a new biopsy was proposed that evidenced the presence of cells compatible with herpes viruses, and after discussed with infectious diseases, the final therapy consisted of dermatological ointment for wound healing and valacyclovir antiviral for 21 days associated with hyperbaric chamber. Subsequently, finding improvement of wounds and regression of the disease in the patient. The recognition of cases not responsive to initial herapies implies an early drug intervention, preventing the disease from worsening, optimizing the excellent treatment and the prolonged use of medications without therapeutic success.