Differential Diagnosis

When a patient presents with a possible Herpes simplex infection, it is important to consider other conditions.  Table 1 describes conditions that should be considered in the differential diagnosis.

Table 1- Differential diagnosis

Other Conditions 

Characteristics

Aphthous Ulcer

Lack of prodromal symptoms and the ulcers do not involve the vermillion border of the lip

Angular Cheilitis

It commonly begins as a dry, irritated patch of skin

Syphilis

Primary infection with a painless genital ulcer; secondary infection is characterized by fever, chills, malaise, and rash

Bacterial Pharyngitis

Fever, chills, enlarged tonsils with exudate

EBV

Viral syndrome of fatigue, cytopenia’s, fever, and rash

Stevens-Johnson/TENS

Severe desquamating rash involving the oral mucosa

 

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