Điều trị tại chỗ cung cấp ít lợi ích lâm sàng. 3. Bắt đầu điều trị ngay sau khi khởi phát triệu chứng. 4. Thời gian điều trị khác nhau phụ thuộc vào bệnh tái phát so với chính. a. Tiểu HSV điều trị 7-10 ngày. b. Tái phát HSV điều trị trong 5 ngày. 5. Có thể sử dụng liệu pháp ức chế cho thanh thiếu niên với 6 tái phát mỗi năm. | 46 SECTION 1 PRINCIPLES OF PEDIATRIC CARE 2. Topical therapy offers little clinical benefit. 3. Initiate treatment shortly after onset of symptoms. 4. Duration of treatment varies dependent on primary vs. recurrent disease. a. Primary HSV treat 7-10 days. b. Recurrent HSV treat for 5 days. 5. Can use suppressive therapy for adolescents with 6 recurrences per year. 6. Management should also include counseling. a. Natural history Treatment is not curative. b. Transmission May shed virus asymptomatically particularly during first year after infection. PELVIC INFLAMMATORY DISEASE PID Spectrum of inflammatory disorders of the upper genital tract in females including salpingitis endometritis and tubo-ovarian abscess TOA . Disproportionately a disease of adolescents. Common Pathogens N. gonorrhea and C. trachomatis are most common at least 50 of cases . May also be a polymicrobial infection with other anaerobic and aerobic bacteria Mycoplasma hominis Bacteroides fragilis E. coli and so on . Diagnosis Clinical diagnosis is based on the presence of the following minimum criteria in the absence of other symptoms 1. Lower abdominal pain 2. Adnexal tenderness 3. Cervical motion tenderness Additional criteria at least one is recommended to enhance diagnostic specificity include the following 1. Oral temperature C 2. Abnormal cervical discharge 3. Elevated ESR or CRP 4. Documented cervical infection with gonorrhea or chlamydia Treatment May be treated as inpatient or outpatient. Criteria for hospitalization 1. If surgical emergencies such as appendicitis cannot be excluded. 2. If patient fails an outpatient regimen. 3. If patient is pregnant. 4. In cases of severe illness . toxic appearance vomiting and so on . 5. If patient has underlying immune deficiency. 6. Although little data support the hospitalization of all adolescents with PID this practice should be strongly considered for education and improved compliance with medical therapy. Inpatient regimens 1. Regimen A
