Diagnosis of herpes simplex virus-1 keratitis using Giemsa stain, immunofluorescence assay, and polymerase chain reaction assay on corneal scrapings.

Abstract

AIMS:

To evaluate three tests used routinely for the diagnosis of herpes simplex virus (HSV) keratitis.

METHODS:

Corneal scrapings from 28 patients with clinically typical dendritic corneal ulcer suggestive of HSV keratitis, and 30 patients with clinically non-viral corneal ulcers, were tested by (i) Giemsa stain for multinucleated giant cells, (ii) immunofluorescence assay (IFA) for HSV-1 antigen, and (iii) polymerase chain reaction (PCR) for HSV-1 DNA, by investigators masked to clinical diagnosis. The control subjects were also investigated by smears and cultures for bacteria, fungus, and Acanthamoeba.

RESULTS:

The specificity and positive predictive values of all three tests for the diagnosis of HSV keratitis were between 95-100%. The sensitivity of IFA and PCR was 78.6% and 81.2%, respectively, and the difference was not significant; however, their sensitivity and negative predictive value were significantly higher than Giemsa stain.

CONCLUSIONS:

While a combination of IFA and PCR constitute the choice of tests in clinically suspected cases of HSV keratitis, multinucleated giant cells in Giemsa stain can pre-empt testing by IFA and PCR in otherwise atypical cases of HSV keratitis.

• Authors: S Farhatullah, S Kaza, S Athmanathan, P Garg, S B Reddy, S Sharma
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 88 Issue 1 Pg. 142-4 (Jan 2004) ISSN: 0007-1161 [Print] England
• PMID: 14693792 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Antigens, Viral
• Azure Stains
• DNA, Viral

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antigens, Viral (analysis)
• Azure Stains
• Child
• Child, Preschool
• DNA, Viral (analysis)
• Female
• Fluorescent Antibody Technique
• Herpesvirus 1, Human (genetics, immunology, isolation & purification)
• Humans
• Infant
• Keratitis, Herpetic (diagnosis)
• Male
• Middle Aged
• Polymerase Chain Reaction
• Predictive Value of Tests
• Sensitivity and Specificity