Genital Herpes: Diagnosis

Because genital herpes is so common, it is diagnosed primarily by symptoms. It can be diagnosed and treated by the family doctor, dermatologists (doctors who specialize in skin diseases), urologists (doctors who specialize in the urinary tract diseases of men and women and the genital organs of men), gynecologists (doctors who specialize in the diseases of women's genital organs) and infectious disease specialists. The diagnosis and treatment of this infectious disease should be covered by most insurance providers.

Laboratory tests may be performed to look for the virus. Because healing sores do not shed much virus, a

sample from an open sore would be taken for viral culture. A sterile cotton swab would be wiped over open sores and the sample used to infect human cells in culture. Cells which are killed by herpes virus have a certain appearance under microscopic examination. The results of this test are available within two to ten days. Other areas which may be sampled, depending upon the disease symptoms in a particular patient, include the urinary tract, vagina, cervix, throat, eye tissues, and cerebrospinal fluid.

Direct staining and microscopic examination of the lesion sample may also be used. A blood test may be performed to see if the patient has antibodies to herpes virus. The results of blood testing are available within one day. The disadvantage of this blood test is that it usually does not distinguish between herpes type 1 and 2, and only determines that the patient has had a herpes infection at some point in his or her life. Therefore, the viral culture test must be performed to be absolutely certain that the sores are caused by herpes virus.

Because genital sores can be symptoms of many other diseases, the doctor must determine the exact cause of the sores. The above mentioned tests are performed to determine that herpes virus is causing the genital sores. Other diseases which may cause genital sores are syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale, herpes zoster, erythema multiform, Behçet's syndrome, inflammatory bowel disease, contact dermatitis, candidiasis, and impetigo.

Because most newborns who are infected with herpes virus were born to mothers who had no symptoms of infection it is important to check all newborn babies for symptoms. Any skin sore should be sampled to determine if it is caused by herpes simplex. Babies should be checked for sores in their mouth and for signs of herpes infection in their eyes.

— Belinda Rowland, PhD