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Internist infectious disease

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Herpes simplex (herpes infection): diagnosis

Alexey Portnov, medical expert
Last reviewed: 17.10.2021

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Diagnosis of herpes simplex (herpetic infection) in case of skin and mucous membrane damage is based on clinical data (characteristic herpetic rash). When CNS, visceral and generalized forms are affected, laboratory diagnostics of herpes simplex (herpetic infection) is necessary. The diagnosis of herpetic infection is confirmed by virus isolation or serologically. The material for isolating the herpes simplex virus from the patient is the contents of herpetic vesicles, saliva, blood, spinal fluid. In the deceased, pieces of the brain, internal organs, are taken for examination. Serological diagnosis of herpes simplex (herpetic infection) is based on the use of RPGA, ELISA and other methods that detect specific antibodies (immunoglobulins of class M, whose level is already growing by the 3-5th day of the disease).

CNS lesion is diagnosed by PCR. For the study, use is made of the cerebrospinal fluid. In addition, the level of antibodies in the cerebrospinal fluid and serum is determined (not earlier than the 10th day of the disease). At a high level, antibodies persist for 1.5-2 months or more. RIF is used to detect a specific antigen in the cerebrospinal fluid. Important is the detection of MRI in characteristic foci in the temporal lobes of the brain.

trusted-source [1], [2], [3], [4], [5], [6], [7], [8]

Indications for consultation of other specialists

Consultation of a neurologist is indicated in case of CNS lesion, dentist - with stomatitis, gynecologist - with genital herpes, ophthalmologist - with ophthalmoherpes.

Indications for hospitalization

Hospitalization is indicated in generalized forms of herpes simplex (herpetic infection), CNS damage, ophthalmoherpes.

Differential diagnosis of herpes simplex (herpetic infection)

Differential diagnosis of herpes simplex (herpetic infection) is carried out, depending on the localization of the process and the form of the disease, with viral stomatitis, herpangina, herpes zoster, chicken pox, pyoderma, meningoencephalitis and meningitis of another etiology, keratoconjunctivitis of adenovirus etiology, eye damage in tularemia, benign lymphatic drainage .

trusted-source [9], [10], [11], [12], [13], [14]

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