Herpes without vesicles: limited, recurrent genital lesions in an immunodebilitated host

We have reported a case of herpes genitalis in a man with acquired immunodeficiency syndrome (AIDS), who was receiving chemotherapy for Hodgkin's disease. The herpes infection was recurrent but limited, without vesicles or the progressive lesions usually seen in AIDS. Studies excluded known causes, and the unusual character of the infection long obscured and delayed diagnosis. Even atypical, culture-negative penile ulcers in immunodebilitated patients may be herpetic. Retrospective study of our patient's penile biopsy specimen using immunoperoxidase reaction was positive for herpesvirus. The existence of effective treatment mandates vigorous pursuit of the diagnosis.