Rapid detection and distinction of cutaneous herpesvirus infections by direct immunofluorescence.
BACKGROUND
Optimal management of cutaneous herpes simplex virus (HSV) and varicellazoster virus (VZV) infections requires rapid, accurate distinction between these pathogens.


OBJECTIVE
In a mixed-case series of suspected cutaneous herpesvirus infections, we compared the diagnostic utility of viral culture and direct immunofluorescence (DIF) using a panel of fluoresceinated monoclonal antibodies against HSV and VZV.


METHODS
Epifluorescence microscopy of smears and viral culture were performed in parallel on 58 lesions.


RESULTS
DIF and culture were equally sensitive (88%) in HSV infections, whereas DIF was four times as sensitive as culture (100% vs 18%) in VZV. DIF either refuted an incorrect clinical diagnosis or permitted definitive laboratory diagnosis of a clinically indeterminate lesion in 7 (12%) of 58 lesions tested.


CONCLUSIONS
DIF is a rapid, simple, sensitive, specific, cost-effective, and clinically useful technique for detecting and distinguishing cutaneous HSV and VZV infections.
Zirn
J R
JR
Department of Dermatology, New York Hospital-Cornell Medical Center, USA.
Tompkins
S D
SD
Huie
C
C
Shea
C R
CR
D000911:Antibodies, Monoclonal; D002644:Chickenpox / Q000175:diagnosis*; D019085:Fluorescent Antibody Technique, Direct; D006561:Herpes Simplex / Q000175:diagnosis*; D006562:Herpes Zoster / Q000175:diagnosis*; D018259:Herpesvirus 1, Human / Q000254:growth & development / Q000276:immunology; D018258:Herpesvirus 2, Human / Q000254:growth & development / Q000276:immunology; D014645:Herpesvirus 3, Human / Q000254:growth & development / Q000276:immunology; D006801:Humans; D012680:Sensitivity and Specificity
D000911:Antibodies, Monoclonal