Herpes simplex infection

Last updated: Friday, 10, December, 2010
Infection SitesAppropriate Tests

Clinical diagnosis, tests not usually required.

If infection is atypical, severe or recurrent: virus detection, culture - lesion swab or vesicle fluid.

Culture or PCR will distinguish HSV types I and II. 

Although the diagnosis can be established by lesion biopsy, this should be avoided if possible as it may exacerbate the infection.

Herpes simplex virus antibodies (serum, CSF) are seldom useful

See also Sexually transmitted diseases

Cutaneous, especially

  • Genital
  • Whitlow

Ocular, especially

  • Keratitis

 

See Keratoconjunctivitis

Oral/oesophageal 

Oesophageal biopsy may be necessary to distinguish HSV infection from candidiasis, CMV infection.

Cerebral 

Virus detection, culture - CSF (including  nucleic acid probe after PCR).
Herpes simplex virus antibodies (serum, CSF) are of little value. Brain biopsy is not indicated.
See also Encephalitis

Disseminated 

Usually only in neonates, immunodeficient patients.
See Immunodeficiency