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Genital herpes diagnosis — DFSRH MCQ

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ModerateSTI diagnosis and managementGenital herpes diagnosisDFSRH

A 29-year-old woman with suspected primary genital herpes has painful vulval ulcers for 3 days, dysuria and tender inguinal nodes. She is not pregnant and has no systemic illness. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — HSV PCR swab from the lesion with STI screen discussion

HSV PCR from a fresh lesion is the most useful diagnostic test for suspected genital herpes, alongside broader STI assessment. Serology alone does not confirm that the current lesion is herpes. BV swabs and urine culture do not address ulcer diagnosis, and syphilis testing should not be delayed for a year if clinically indicated. The pearl is to swab lesions early because viral detection falls as lesions heal.

Reference: BASHH Guidelines: Genital Herpes