1st order laboratory parameters – obligatory laboratory tests.
- Herpes simplex virus type 1/2 antibody (IgG; IgM).
- Herpes simplex virus type 1/2 virus culture from vesicle contents (= herpes simplex virus culture).
- HSV-1-PCR/HSV-2-PCR (nucleic acid amplification technique (NAT)) – direct detection of viral DNA by PCR (polymerase chain reaction) from efflorescences.
- Immunofluorescence (antibody staining).
- Electron microscopic direct detection
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Bacteria
- Chlamydia trachomatis (lymphogranuloma venereum) – serology: Chlamydia trachomatis.
- Neisseria gonorrhoeae (gonorrhea, gonorrhea) – genital swab for pathogen and resistance, specifically for Neisseria gonorrhoeae.
- Treponema pallidum (syphilis, lues) – antibodies against Treponema pallidum (TPHA, VDRL, etc.).
- Ureaplasma urealyticum
- Viruses
- HIV (AIDS)
- Human papilloma virus [HPV] (condylomata acuminata).
- Fungi/Parasites
- Fungi: Candida albicans and others Candida species genital swab – pathogen and resistance).
- Trichomonas vaginalis (trichomoniasis, colpitis) – antigen detection.
Serological parameters in HSV infection (modified after).
HSV serology | HSV-1 PCR | HSV-2-PCR | Infection status | |||
HSV-1/2 IgG | HSV-1-IgG | HSV-2-IgG | HSV-1/2-IgMa | |||
– – | – – | – – | – – | – – | – – | Receptive |
– – | – – | – – | – or + | + | – – | acute HSV-1 primary infection |
+ | – – | + | – or + | + | – – | Acute primary HSV-1 infection with HSV-2 latency. |
+ | + | – – | – or + | + | – – | HSV-1 infection or recurrence (reactivation or reinfection). |
+ | + | – – | + | – – | – – | No statement possible without pathogen detection |
– – | – – | – – | – or + | – – | + | acute HSV-2 primary infection |
+ | + | – – | – or + | – – | + | HSV-2 primary infection with HSV-1 latency. |
+ | – – | + | – or + | – – | + | HSV-2 infection or recurrence |
+ | + | + | + | + | + | No statement possible without pathogen detection |
+ | + | – – | – – | – – | – – | expired HSV-1 infection/latency |
+ | – – | + | – – | – – | – – | expired HSV-2 infection/latency |
+ | + | + | – – | – – | – – | expired HSV-1 and HSV-2 infection |
Legend
- PCR = polymerase chain reaction.
- A A negative result for HSV-1/2 IgM does not rule out acute infection.