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If the Pap smear demonstrates giant cells with intranuclear inclusions,
the cytologist may report "possible herpes virus."
In the asymptomatic patient with an otherwise normal Pap smear, this is
of no clinical significance. Some physicians will bring the patient back for a herpes
culture (if her history is negative for herpes), while others will ignore this finding.
If the Pap shows significant degrees of
inflammation,
the presence of herpes virus may explain the inflammation. A follow-up Pap avoiding any
time of herpes recurrence may give more reliable information. In patients suspected of
having herpes, a herpes culture is ideal for confirming the diagnosis. If such a culture
is unavailable, scraping an active lesion and preparing a Pap smear from the secretions
can be useful. In this case, the cytologist looks carefully for herpes-related microscopic
findings.
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