Herpes zoster infection (shingles) Quiz: Ace Your Exams

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A 75-year-old man presents to his primary care physician for evaluation of a painful rash over the left side of his face for the past four days. He reports his symptoms were preceded by malaise and low grade fevers at home. He has a history of hypertension, diabetes, and chickenpox in his youth. Temperature is 37.5°C (99.5°F), blood pressure is 154/70 mmHg, pulse is 90/min, respiratory rate is 14/min, and oxygen saturation is 98% on room air. On physical examination, a vesicular rash is noted in the V1 distribution over the left face. Several vesicles are noted over the distal left tip of the nose. The rash does not cross the midline of the face. Mental status and neurologic exams are within normal limits. Which of the following diagnostic studies should be performed next?  

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