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Herpes Cerebrospinal Fluid Test

Last updated Jan. 10, 2019

Approved by: Maulik P. Purohit MD, MPH

The Herpes Cerebrospinal Fluid Test uses cerebrospinal fluid (CSF) as a sample for testing and analysis.

What are the other Names for this Test? (Equivalent Terms)

  • Herpes Cerebrospinal Fluid Culture Test
  • Herpes CSF Test
  • HSV-2 IgM or IgG Cerebrospinal Fluid Test 

What is Herpes Cerebrospinal Fluid Test? (Background Information)

  • Herpes viruses are a large group of viruses, many of which cause human illnesses
  • Herpes simplex 1 virus (HSV-1) primarily infects the oral cavity and mouth, causing blisters and cold sores. HSV-1 is mainly spread through the saliva
  • Herpes simplex 2 virus (HSV-2) primarily infects the region around the genitals and anus, causing painful blisters. HSV-2 is mainly spread through sexual contact
  • HSV-1 is also known to infect the region around the genitals and anus, as HSV-2 is known to infect the oral cavity and mouth. Herpes virus can also be transmitted to a newborn during delivery
  • Herpes virus causes symptoms within 3-5 days; some symptoms may persist for 2-3 weeks. They may be so mild, so as to go unnoticed
  • After this time, the virus enters a period of dormancy, called the latent phase. The virus may emerge during times of immunosuppression, such as illness and stress
  • There are no known cures for herpes virus infections. However, antiviral drugs are sometimes used to shorten the active phase, or the period of time during which the virus “sheds”. This (virus “sheds”) means the time of infection during which the herpes virus is actively multiplying in the body and is released into various body fluids. During the active shedding period, the virus may be transmitted or spread from one person to another
  • After infection by herpes virus, the immune system creates antibodies specific to it. Antibodies are proteins that recognize foreign objects, such as herpes, and help rid them from the body. The presence of antibodies against herpes virus in the bloodstream is indicative of a prior exposure to herpes virus. This is diagnostic of a current or past infection

The Herpes Test detects the presence of herpes virus in a sample of body fluid, using one of several methods. These include:

  • Culturing: The specimen is used to infect test cells, which can be analyzed and further identified as either HSV-1 or HSV-2
  • Antibody testing: The specimen is analyzed for antibodies against herpes virus. These include short-term IgM antibodies and long-term IgG antibodies, which continue to be produced for the rest of an individual’s life
  • DNA testing: The specimen is analyzed for the presence of herpes virus DNA. The virus can further be identified as either HSV-1 or HSV-2. This test is more sensitive than other tests

The Herpes Cerebrospinal Fluid Test uses cerebrospinal fluid (CSF) as a sample for testing and analysis. 

What are the Clinical Indications for performing the Herpes Cerebrospinal Fluid Test?

Following are the clinical indicators for performing a Herpes Cerebrospinal Fluid Test:

  • Blistering around the mouth, anus, or genitals
  • Sexual contact with an individual known to be infected by HSV
  • Fever, headache
  • Swollen lymph nodes

How is the Specimen Collected for Herpes Cerebrospinal Fluid Test?

Following is the specimen collection process for Herpes Cerebrospinal Fluid Test:

Sample required: Cerebrospinal fluid (CSF)

Process: Insertion of a thick needle into the lower back for a sample of spinal fluid.

Preparation required: No special preparation is needed prior to the test. 

What is the Significance of the Herpes Cerebrospinal Fluid Test Result?

The significance of Herpes Cerebrospinal Fluid Test is explained:

  • A positive test may indicate an infection with HSV-1 or HSV-2
  • A negative test may indicate:
    • Not enough time has passed to allow for the production of detectable levels of anti-HSV antibodies
    • There may be an infection by a similar virus
    • The individual is incapable of producing anti-HSV antibodies and may be too young

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. 

Additional and Relevant Useful Information:

  • Herpes virus usually causes a self-limiting disease; in other words, it resolves without the need for a significant medical intervention. However, the symptoms may be alleviated through rest, consumption of fluids, and with proper medications
  • Herpes virus is a common infectious agent. An estimated 50% of US adults are infected with HSV-1 and 17% with HSV-2

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 4, 2015
Last updated: Jan. 10, 2019