Herpes simplex and varicella-zoster infections: Clinical and laboratory diagnosis

One of a dentist's most common diagnostic challenges is determining the cause of vesiculo-ulcerative disorders of the oral cavity. The most common etiology of oral vesicles is herpes simplex virus (HSV) infection. Varicella-zoster virus (VZV) is a less common etiology of vesicles in the oral cavity. Dentists often are able to differentiate these two viruses based on the clinical presentation of infectious symptoms; however, further laboratory testing is required to identify herpetically induced vesiculo-ulcerative lesions definitively. This article reviews the basic clinical signs and symptoms of HSV and VZV infection and describes the various laboratory tests that can determine the definitive etiology of the vesiculo-ulcerative disorder.