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Herpes simplex (herpes infection) - Diagnosis
Last reviewed: 03.07.2025
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Diagnosis of herpes simplex (herpes infection) with lesions of the skin and mucous membranes is based on clinical data (characteristic herpes rash). In case of lesions of the central nervous system, visceral and generalized forms, laboratory diagnosis of herpes simplex (herpes infection) is necessary. The diagnosis of herpes infection is confirmed by isolation of the virus or serologically. The material for isolation of the herpes simplex virus from the patient is the contents of herpes vesicles, saliva, blood, cerebrospinal fluid. Pieces of the brain and internal organs are taken from the deceased for research. Serological diagnosis of herpes simplex (herpes infection) is based on the use of RPGA, ELISA and other methods that detect specific antibodies (immunoglobulins of class M, the level of which increases by the 3rd-5th day of the disease).
CNS damage is diagnosed using PCR. Cerebrospinal fluid is used for the study. In addition, the level of antibodies in the cerebrospinal fluid and blood serum is determined (not earlier than the 10th day of illness). Antibodies remain at a high level for 1.5-2 months or more. RIF is used to detect a specific antigen in the cerebrospinal fluid. It is important to detect characteristic foci in the temporal lobes of the brain using MRI.
[ Indications for consultation with other specialists
A consultation with a neurologist is indicated in case of damage to the central nervous system, a dentist - in case of stomatitis, a gynecologist - in case of genital herpes, an ophthalmologist - in case of ophthalmic herpes.
Indications for hospitalization
Hospitalization is indicated for generalized forms of herpes simplex (herpes infection), CNS lesions, and ophthalmic herpes.
Differential diagnosis of herpes simplex (herpes infection)
Differential diagnostics of herpes simplex (herpes infection) is carried out, depending on the localization of the process and the form of the disease, with viral stomatitis, herpangina, herpes zoster, chickenpox, pyoderma, meningoencephalitis and meningitis of other etiologies, keratoconjunctivitis of adenoviral etiology, eye damage in tularemia, benign lymphoreticulosis.