In females, herpetic infection may be complicated by urinary retention due either to local pain or to neurogenic bladder due to radiculitis. Herpes may cause an extensive necrotising lesion of the cervix which causes a sanguineous vaginal discharge and may resemble cervical carcinoma.
HSV infection may produce no symptoms and asymptomatic viral shedding from the cervix or other sites may occur.
Relapse may be attributed to emotional or physical stress, fever, trauma, hormonal changes, menstruation, sunlight, alcohol etc. Relapses are characterised by a milder prodromal period, lesions of 4 to 5 days average duration healing in 1 to 2 weeks and a milder degree of lymphadenopathy.
HSV has a high morbidity and mortality in neonates. The infection can be transmitted from mother to infant during parturition if the mother is actively shedding the virus. A higher rate of neonatal infection occurs if primary infection occurs late in the pregnancy and there is insufficient time for maternal antibody to develop and be transferred to the foetus.