Comparison of virus culture and the polymerase chain reaction for diagnosis of mucocutaneous herpes simplex virus infection.
OBJECTIVE
The diagnosis of mucocutaneous herpes simplex virus (HSV) is hampered by suboptimal sensitivity of virus culture and atypical clinical morphology.


OBJECTIVE
To compare the diagnostic usefulness of the polymerase chain reaction (PCR) and virus culture.


METHODS
Consecutive samples from 246 patients at an urban sexually transmitted diseases clinic were tested for HSV by both PCR and virus culture.


RESULTS
Only 59% of HSV-positive samples were correctly diagnosed by the clinician; 11% had an atypical appearance. HSV-positive lesions were more often vesiculoulcerative or crusted than HSV-negative lesions, and of shorter median duration. Thirty-one samples were PCR positive and virus culture negative; these were often from crusted or older lesions. However, PCR was negative in 27 instances in which HSV was diagnosed clinically, of which 2 were vesicular and 15 ulcerative.


CONCLUSIONS
HSV PCR is more rapid and sensitive than virus culture for diagnosis of mucocutaneous lesions. The data suggesting that PCR may be suboptimally sensitive need to be further investigated.
Safrin
S
S
Department of Medicine, University of California, San Francisco, USA.
Shaw
H
H
Bolan
G
G
Cuan
J
J
Chiang
C S
CS
D005260:Female; D006561:Herpes Simplex / Q000175:diagnosis*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D018139:Simplexvirus / Q000302:isolation & purification; D012874:Skin Diseases, Infectious / Q000175:diagnosis*