Genital herpes can be associated with chronic recurrent urinary tract symptoms, such as dysuria, urgency, and frequency (Item 136-9). When these symptoms occur in the context of negative urine culture, consider testing for genital herpes with HerpeSelect IgG assay, which is type-specific for Type 1 and 2 genital herpes. The CDC estimates that one out of five Americans has genital herpes, with most of these cases undiagnosed. Unfortunately, if patients have symptoms they are often atypical (e.g., complaining of urinary tract symptoms or chronic yeast infection symptoms). Clinicians must consider genital herpes in the differential diagnosis of chronic dysuria, particularly when the urine cultures are negative.—R. Mimi Secor, FNP-BC, FAANP, Upton, Mass. (140-11)
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