A 30-year old homosexual male presented with a one week history of painful vesicular perinal lesions. There was an associated history of body aches, fever and joint pains. He claimed that his paner had similar lesion on his penis about one month age with associated dysuria which has resolved now. The microscopy of the lesion revealed multinucleated syncytial cells with intranuclear inclusion bodies and perinuclear halo. The most liekly causative agent for these lesions is -

Herpes simplex infections Recurrences of herpes simplex infection are very common and primarily affect the nasolabial and anogenital areas . As immune suppression worsens, the ulcers take longer to heal and become more extensive. Ulcers that persist for more than 4 weeks are AIDS-defining. The diagnosis is clinical, but PCR of vesicle fluid or from ulcer swabs may be diagnostic with unusual presentations. Response to a course of antiviral drug such as aciclovir is good but relapses are common. Frequent relapses that persist despite A should be treated with aciclovir 400 mg twice daily for 6-12 months . Ref Harrison20th edition pg 987