A 24-year-old man comes to the physician with painful blisters on the shaft of his penis. The lesions erupted 2 days ago. The patient has had 5 lifetime sexual partners and is currently sexually active with one female partner; he uses condoms inconsistently. Examination shows multiple vesicular lesions on the penis. HIV testing is negative. The patient has had several similar episodes every year for the past 2 years but had been too embarrassed to seek treatment until now. Which of the following is the best diagnostic test for this patient's condition?

Question

A 24-year-old man comes to the physician with painful blisters on the shaft of his penis.  The lesions erupted 2 days ago.  The patient has had 5 lifetime sexual partners and is currently sexually active with one female partner; he uses condoms inconsistently.  Examination shows multiple vesicular lesions on the penis.  HIV testing is negative.  The patient has had several similar episodes every year for the past 2 years but had been too embarrassed to seek treatment until now.  Which of the following is the best diagnostic test for this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: The finding of multiple painful genital ulcers and constitutional symptoms in a sexually active patient is highly suggestive of primary genital infection with herpes simplex virus.  The diagnosis can be established by PCR testing, direct fluorescence antibody testing, or Tzanck smear.

A 24-Year-Old Man Comes to the Physician with Painful Blisters