How is varicella-zoster virus (VZV) infection diagnosed?

Updated: Feb 15, 2019
  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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When the presentation includes the typical dermatomal rash, additional studies are not required. Studies to consider in specific situations include the following:

  • If the diagnosis is in doubt, a Tzanck smear or culture of vesicular fluid can be performed

  • In cases of zoster sine herpete, DNA analysis via PCR can be used

  • In cases of acyclovir-resistant VZV, detections of mutations in thymidine kinase can be determined by PCR and sequence analysis

  • MRI may be useful if myelitis or encephalitis is suspected

  • Lumbar puncture may be helpful if signs suggest myelitis or encephalitis

See Workup for more detail.

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