Need help with a case study

[Christine2009]

I have a case study that I need to turn in on Monday, July 20th and totally stumped. This is the senerio.

A 24 y/o F pt is being prepared for delivery of her baby. Upon examination, the OB/GYN notices genital sores and elephantiasis of the labia. The pt had previously had swollen and painful lymph nodes near her groin, but did not seek TX due to thinking it was related to the pregnancy.

Would this be Genital Herpes? We are suppose to find the disease, causitive agent, what the risk is for the unborn fetus, how the doctor should treat the pt and unborn child, if left untreated, what SX if any would the newborn experience and how the disease might progress in the woman if left untreated.

Any help would be greatly appreciated!

[LucasRN]

This could be Genital Herpes. Sores are tyically found inside the lady parts and lymph nodes are affected and become swollen. If this is a new outbreak or the disease was contracted during pregnancy the MD would most probably hang IV antibiotics and the patient would most likely have a c-section in order to minimize any chance for the fetus to contract the disease.

Good Luck.

[Christine2009]

Thank you, would this also cause elephantasis of the labia?

[Daytonite, BSN, RN]

if this is genital herpes, and i can't find this symptom of the elephantiasis of the labia as belonging to genital herpes, the causative agent is herpes simplex virus ii [hsv]. elephantiasis, as best as i can determine, is an inflammatory skin condition that primarily occurs in the genital and pelvic area due to chronically obstructed lymph vessels (per taber's cyclopedic medical dictionary). since genital herpes is a chronic disease, i would assume that elephantiasis would be a manifestation of a rather aggressive form of the virus in someone, i.e., it is their body's response to attempting to fend off the viral attacks. i could not find anything about elephantiasis in any of my 3 books on signs and symptoms here at home. i found lots on genital herpes, but none mentioned anything about elephantiasis.

• http://www.health-disease.org/infectious-diseases/herpes-simplex.htm - "genital herpes: seen in active young adults. there is at first itching of the genital area, followed by development of small, painful blisters or ulcers. the person may feel unwell, feverish. inguinal lymph glands are enlarged."
  

the fetus comes into contact with the virus because it ascends up the birth canal when the labor process begins and after the membranes rupture or the fetus comes into direct contact with any of the genital secretions from a lesion during the birth process. an infected newborn will have outbreaks of clusters of vesicles, unstable temperatures, be lethargic, have poor suck, could progress to seizures, encephalitis, jaundice, purpura, neurologic impairment and death. treatment for baby is to prevent exposure to the virus so a cesarean section is performed. if the baby does get the infection the will receive antivirals. antivirals are given to the mother. herpes can never be cured. left untreated the mother will experience adenopathy, dysuria, leukorrhea, dyspareunia, and periodic outbreaks of fluid filled vesicles that will appear on the cervix, labia, perianal skin, vulva, lady parts and orifice. complications include premature labor, microencephaly and uterine growth retardation during pregnancy, increased risk for cervical cancer, risk for developing urethral stricture, colitis, neurologic disorders and uremia with multiple organ involvement.

[Christine2009]

I looked through all the books I have here at home also, and could not find elephantisasis as a SX of genital herpes. I do though think that is what it is and the link you posted, is the same one I looked at myself. I just wanted to get clarification of what I thought it might be before I write up the report.

Thank you for all your help, you guys are awesome!