title: Isolation of herpes simplex virus from the genital tract during symptomatic recurrence on the buttocks.
abstract: OBJECTIVE
  To estimate the frequency of isolation of herpes simplex virus (HSV) from the genital tract when recurrent herpes lesions were present on the buttocks.
  
  
  METHODS
  Data were extracted from a prospectively observed cohort attending a research clinic for genital herpes infections between 1975 and 2001. All patients with a documented herpes lesion on the buttocks, upper thigh or gluteal cleft ("buttock recurrence") and concomitant viral cultures from genital sites including the perianal region were eligible.
  
  
  RESULTS
  We reviewed records of 237 subjects, 151 women and 86 men, with a total of 572 buttock recurrences. Of the 1,592 days with genital culture information during a buttock recurrence, participants had concurrent genital lesions on 311 (20%, 95% confidence interval [CI] 14-27%) of these days. Overall, HSV was isolated from the genital region on 12% (95% CI 8-17%) of days during a buttock recurrence. In the absence of genital lesions, HSV was isolated from the genital area on 7% (95% CI 4%-11%) of days during a buttock recurrence and, among women, from the vulvar or cervical sites on 1% of days.
  
  
  CONCLUSIONS
  Viral shedding of herpes simplex virus from the genital area is a relatively common occurrence during a buttock recurrence of genital herpes, even without concurrent genital lesions, reflecting perhaps reactivation from concomitant regions of the sacral neural ganglia. Patients with buttock herpes recurrences should be instructed about the risk of genital shedding during such recurrences.
  
  
  METHODS
  II-2.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington 98195, USA.
authors.forename: Katrina
authors.initials: K
authors.lastname: Kerkering
authors.forename: Carolyn
authors.initials: C
authors.lastname: Gardella
authors.forename: Stacy
authors.initials: S
authors.lastname: Selke
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Krantz
authors.forename: Lawrence
authors.initials: L
authors.lastname: Corey
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
mesh_terms: D000293:Adolescent; D000328:Adult; D002081:Buttocks / Q000821:virology*; D005260:Female; D005835:Genitalia / Q000821:virology*; D018023:HIV Seronegativity; D006561:Herpes Simplex / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D018139:Simplexvirus / Q000302:isolation & purification*; D017201:Virus Shedding