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Diagnosis of herpes simplex virus infections in the clinical laboratory by LightCycler PCR.
Diagnosis of varicellazoster virus infections in the clinical laboratory by Light-Cycler PCR.
Real-time PCR in clinical microbiology: applications for routine laboratory testing [published correction appears in Clin Microbiol Rev. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Famciclovir for the treatment of acute herpes zoster: effects on acute disease and postherpetic neuralgia. Oral acyclovir therapy accelerates pain resolution in patients with herpes zoster: a meta-analysis of placebo-controlled trials. The effect of treating herpes zoster with oral acyclovir in preventing postherpetic neuralgia. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.


This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. The burned sensation resolved after one day; however, a couple of days later, he noticed tingling on the right side of the hard palate that progressed to a scalded sensation. This was accompanied by tenderness along the right temporal area and discomfort below the right ear.
He denied a history of oral lesions.Examination revealed erythema that was confined to the right side of the hard palate with multiple ulcerations and vesicles (Figures 1 and 2).
HSV infection is also less likely in this patient because he has no history of oral ulcers. However, herpes zoster cannot be differentiated from HSV infection based on clinical findings alone because HSV lesions can occur unilaterally and be indistinguishable from those caused by the varicella zoster virus. A more definitive clinical diagnosis of herpes zoster requires the presence of an associated cutaneous herpetiform rash in the appropriate distribution of the affected nerve.Laboratory testing of affected tissue or fluid from the vesicles is needed for a conclusive herpes zoster diagnosis. Acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) are available for the treatment of herpes zoster.


Current evidence supports using these agents to hasten resolution of lesions and acute pain, as well as to attenuate the development of postherpetic neuralgia. The benefit of adding oral steroids to antiviral treatment is unclear and potentially harmful. Acyclovir combined with steroids does not reduce the incidence or duration of postherpetic neuralgia.9The oral lesions in this patient differ significantly from those typically associated with primary syphilis.
With primary syphilis, a papule develops on loose, nonkeratinized mucosa, then breaks down into a large, painless, solitary ulcer with a raised border.Recurrent aphthous stomatitis (canker sores), HSV, or varicella zoster virus can appear as grouped or clustered oral ulcerations.
However, recurrent aphthous stomatitis does not have a vesicular phase and usually appears as a single ulcer or a small number of ulcers.



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