Vesicles can be cultured but PCR (polymerase chain reaction) is more sensitive and accurate. Both of these procedures can determine if the infection is caused by herpes simplex virus type I (HSV-1) or herpes simplex virus type II (HSV-2). A biopsy is rarely required. Always consider HIV testing in patients who present with any sexually transmitted disease.
HSV-1 and HSV-2 antibody titers can be determined by blood tests and will determine if an individual has been infected with either virus. Patients who are HSV-2 positive by definition have genital herpes and are capable of shedding the virus asymptomatically and infecting others. Always include HSV-1 and HSV-2 tests for patients who request screening for sexually transmitted diseases.