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Oral Herpes (cont.)

Oral Herpes (HSV-1) Diagnosis

A doctor will base a presumptive diagnosis on information provided by the patient and on the physical examination. The characteristic appearance of the herpes sores leaves little doubt about the diagnosis. This appearance helps distinguish oral herpes from oral thrush, shingles, gonorrhea, and syphilis. In addition, chapped or sunburned lips can resemble oral herpes, but the tissue stain (Tzanck smear, see below) shows no virus-induced cell changes. Further testing is usually not necessary but is sometimes done.

If a definitive diagnosis is needed, because, for example, the infection involves other organ systems, the doctor may conduct laboratory tests listed below:

  • A sample (tissue or fluid) from the sores to identify the virus as HSV
  • A viral culture analysis
  • A staining test called the Tzanck smear (shows nonspecific cell nucleus changes due to HSV)
  • Antigen and antibody studies (serologic and PCR tests to determine if infection is caused by HSV-1 or HSV- 2)
Medically Reviewed by a Doctor on 5/14/2014

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