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A nucleic acid amplification test (NAAT) of vesicle fluid, genital or mouth swabs is the standard diagnostic method, although the virus grows readily and can be visualized by electron microscopy (EM). Topical, oral and intravenous preparations of aciclovir and other agents with better oral absorption, including valaciclovir and famci-clovir, are available. Varicella zoster virus (VZV), which has only one serological type, causes the acute primary infection known as chickenpox and its recurrence, which is called shingles.

The figure shows the chromatin switch model for the mechanism of the decision by herpes simplex virus (HSV) to undergo lytic versus latent infection pathways. The ratio between serum and CSF antibody may indicate local production and can help in the diagnosis of HSV encephalitis. MRI or CT scans of the brain may detect temporal lobe lesions that are typical of herpes encephalitis.

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