Question

A 26-year old white female presents in her physician’s office with genital itching and sharp, severe pain on the labia. She complains of three previous episodes of pain over the past 6 months, each of which were followed by the appearance of red sores which crusted and healed without a scar. On examination the physician observes a cluster of small red blisters localized in the area of the worst pain. No significant discharge was observed from the vagina. The patient’s urine was clear and yellow. Urinalysis revealed normal specific gravity, no sugar, no protein, no white blood cells or red blood cells and no bacteria. The patient’s temperature was 36.5C. The patient history reveals that she is unmarried. She is moderately sexually active and currently using an oral contraceptive which she has been taking for about 4 years. The woman stated that she has had 5 sexual partners over the past year. She reported that her episodes have become progressively more severe. What is the cause of this woman’s complaint? As her physician, would you recommend that this woman modify her sexual activity? Is there an effective treatment for this condition? What serious long-term risk does this woman have?