Herpes Pharyngitis

Epidemiology

The cause of herpes pharyngitis is a group of herpesviruses including herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). Infection with herpes simplex virus is a common ailment; approximately 65% of adults in the general U.S. population carry antibodies to HSV-1. Approximately 25% carry antibodies to HSV-2. The latter behaves as a sexually transmitted disease, and seroprevalence is increased in postpubescent adults. Homosexual and bisexual men with human immunodeficiency virus (HIV) infection harbor the rate of seropositivity of approximately 75%. Heterosexual men and women with HIV infection also have high rates of carriage of HSV-2.

Clinical Findings

The hallmarks of the herpetic lesions are vesicles and ulcers with an erythematous base occurring at a mucocutaneous site. HSV-1 most commonly causes lesions on the mouth or lips; HSV-2 generally infects genital and perianal regions. During primary exposure, the initial episode lasts for approximately 2.5 weeks, whereas recurrent episodes usually resolve within 10 days. Frequently there is a prodromal syndrome involving paresthesias at the site of the developing lesion. The patients classically present with throat pain, erythema, and changes occasionally associated with lymphadenopathy.