What is the role of lab testing in the diagnosis of herpes simplex encephalitis (HSE)?

Updated: Jul 17, 2018
  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Routine laboratory tests are generally not helpful in the diagnosis of HSE but may show evidence of infection or detect renal disease. The diagnosis can be confirmed only by means of PCR or brain biopsy.

Studies that may be helpful in patients with suspected HSE include the following:

  • Serologic analysis of blood or CSF: Retrospective diagnosis only; not for acute diagnosis and management

  • Tzanck preparations of vesicular lesions: For confirmation of HSV in neonates with HSE

  • Quantification of intrathecal antibodies: For evidence of CNS antibody response

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