Utility of direct immunofluorescence and virus culture for detection of varicella-zoster virus in skin lesions.
A direct immunofluorescence assay (DFA) with a monoclonal antibody from Ortho Diagnostic Systems was compared with conventional cell culture for the rapid detection of varicella-zoster virus (VZV) in 140 dermal lesions from 133 patients. A total of 79 (56%) specimens were positive for VZV: 40 (51%) by DFA alone, 2 (3%) by culture only, and 37 (47%) by both culture and DFA. After discordant analysis, the sensitivities and negative predictive values, respectively, were 97.5% (77 of 79) and 96.8% (61 of 63) for DFA and 49.4% (39 of 79) and 60.4% (61 of 101) for viral culture. Of the 39 positive viral cultures, VZV was isolated from 38 (97%) cultures in A549 cells, 23 (59%) in primary rhesus monkey kidney cells, and only 16 (41%) in MRC-5 cells. We conclude that DFA is the optimal method for rapid identification of VZV. In addition, better recovery of VZV in culture may be achieved by using A549 cells.
Coffin
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Department of Pediatrics, Children's Hospital of Philadelphia and School of Medicine, University of Pennsylvania 19104, USA.
Hodinka
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D000328:Adult; D002460:Cell Line; D002648:Child; D019085:Fluorescent Antibody Technique, Direct; D006566:Herpesviridae Infections / Q000175:diagnosis*; D014645:Herpesvirus 3, Human / Q000254:growth & development / Q000302:isolation & purification*; D006801:Humans; D011446:Prospective Studies; D017193:Skin Diseases, Viral / Q000821:virology*; D010948:Viral Plaque Assay