[6] Lumbar puncture with cerebrospinal fluid results demonstrating aseptic meningitis pattern is necessary for diagnosis and polymerase chain reaction is used to detect viral presence.

[13] Differential diagnoses are broad including other causes of meningitis (bacterial, fungal, drug-induced), systemic infection, vasculitis, auto-immune disease, and cancer.

[14] As such, patient presentation of fever, headache, stiff neck, and altered mental status is not sufficient information for diagnosis and lumbar puncture must be performed to properly diagnose meningitis.

[4] Cerebrospinal fluid findings in herpes meningitis present with lymphocytic pleocytosis, normal glucose, and normal-to-elevated protein.

[8] DNA analysis techniques such as polymerase chain reaction is the gold standard for detection of herpes virus in patient CSF fluid due to high specificity[4] and has been able to detect the HSV-2 virus in patients presenting without genital lesions as well as those experiencing recurrent meningitis.