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. 1995 Oct;33(10):2792–2795. doi: 10.1128/jcm.33.10.2792-2795.1995

Utility of direct immunofluorescence and virus culture for detection of varicella-zoster virus in skin lesions.

S E Coffin 1, R L Hodinka 1
PMCID: PMC228580  PMID: 8567930

Abstract

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.

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Selected References

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  1. Arvin A. M., Koropchak C. M. Immunoglobulins M and G to varicella-zoster virus measured by solid-phase radioimmunoassay: antibody responses to varicella and herpes zoster infections. J Clin Microbiol. 1980 Sep;12(3):367–374. doi: 10.1128/jcm.12.3.367-374.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Balfour H. H., Jr, Bean B., Laskin O. L., Ambinder R. F., Meyers J. D., Wade J. C., Zaia J. A., Aeppli D., Kirk L. E., Segreti A. C. Acyclovir halts progression of herpes zoster in immunocompromised patients. N Engl J Med. 1983 Jun 16;308(24):1448–1453. doi: 10.1056/NEJM198306163082404. [DOI] [PubMed] [Google Scholar]
  3. Balfour H. H., Jr Intravenous acyclovir therapy for varicella in immunocompromised children. J Pediatr. 1984 Jan;104(1):134–136. doi: 10.1016/s0022-3476(84)80611-3. [DOI] [PubMed] [Google Scholar]
  4. Balfour H. H., Jr Varicella-zoster virus infections in the immunocompromised host. Natural history and treatment. Scand J Infect Dis Suppl. 1991;80:69–74. [PubMed] [Google Scholar]
  5. Cohen P. R., Beltrani V. P., Grossman M. E. Disseminated herpes zoster in patients with human immunodeficiency virus infection. Am J Med. 1988 Jun;84(6):1076–1080. doi: 10.1016/0002-9343(88)90315-4. [DOI] [PubMed] [Google Scholar]
  6. Drew W. L., Mintz L. Rapid diagnosis of varicella-zoster virus infection by direct immunofluorescence. Am J Clin Pathol. 1980 May;73(5):699–701. doi: 10.1093/ajcp/73.5.699. [DOI] [PubMed] [Google Scholar]
  7. Feldman S., Lott L. Varicella in children with cancer: impact of antiviral therapy and prophylaxis. Pediatrics. 1987 Oct;80(4):465–472. [PubMed] [Google Scholar]
  8. Folkers E., Vreeswijk J., Oranje A. P., Duivenvoorden J. N. Rapid diagnosis in varicella and herpes zoster: re-evaluation of direct smear (Tzanck test) and electron microscopy including colloidal gold immuno-electron microscopy in comparison with virus isolation. Br J Dermatol. 1989 Sep;121(3):287–296. doi: 10.1111/j.1365-2133.1989.tb01421.x. [DOI] [PubMed] [Google Scholar]
  9. Gleaves C. A., Lee C. F., Bustamante C. I., Meyers J. D. Use of murine monoclonal antibodies for laboratory diagnosis of varicella-zoster virus infection. J Clin Microbiol. 1988 Sep;26(9):1623–1625. doi: 10.1128/jcm.26.9.1623-1625.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jura E., Chadwick E. G., Josephs S. H., Steinberg S. P., Yogev R., Gershon A. A., Krasinski K. M., Borkowsky W. Varicella-zoster virus infections in children infected with human immunodeficiency virus. Pediatr Infect Dis J. 1989 Sep;8(9):586–590. doi: 10.1097/00006454-198909000-00003. [DOI] [PubMed] [Google Scholar]
  11. Kido S., Ozaki T., Asada H., Higashi K., Kondo K., Hayakawa Y., Morishima T., Takahashi M., Yamanishi K. Detection of varicella-zoster virus (VZV) DNA in clinical samples from patients with VZV by the polymerase chain reaction. J Clin Microbiol. 1991 Jan;29(1):76–79. doi: 10.1128/jcm.29.1.76-79.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Novelli V. M., Brunell P. A., Geiser C. F., Narkewicz S., Frierson L. Herpes zoster in children with acute lymphocytic leukemia. Am J Dis Child. 1988 Jan;142(1):71–72. doi: 10.1001/archpedi.1988.02150010081029. [DOI] [PubMed] [Google Scholar]
  13. Olding-Stenkvist E., Grandien M. Early diagnosis of virus-caused vesicular rashes by immunofluorescence on skin biopsies. I. Varicella, zoster and herpes simplex. Scand J Infect Dis. 1976;8(1):27–35. [PubMed] [Google Scholar]
  14. Pérez J. L., García A., Niubò J., Salvà J., Podzamczer D., Martín R. Comparison of techniques and evaluation of three commercial monoclonal antibodies for laboratory diagnosis of varicella-zoster virus in mucocutaneous specimens. J Clin Microbiol. 1994 Jun;32(6):1610–1613. doi: 10.1128/jcm.32.6.1610-1613.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rawlinson W. D., Dwyer D. E., Gibbons V. L., Cunningham A. L. Rapid diagnosis of varicella-zoster virus infection with a monoclonal antibody based direct immunofluorescence technique. J Virol Methods. 1989 Jan;23(1):13–18. doi: 10.1016/0166-0934(89)90084-0. [DOI] [PubMed] [Google Scholar]
  16. Sadick N. S., Swenson P. D., Kaufman R. L., Kaplan M. H. Comparison of detection of varicella-zoster virus by the Tzanck smear, direct immunofluorescence with a monoclonal antibody, and virus isolation. J Am Acad Dermatol. 1987 Jul;17(1):64–69. doi: 10.1016/s0190-9622(87)70172-8. [DOI] [PubMed] [Google Scholar]
  17. Schmidt N. J., Gallo D., Devlin V., Woodie J. D., Emmons R. W. Direct immunofluorescence staining for detection of herpes simplex and varicella-zoster virus antigens in vesicular lesions and certain tissue specimens. J Clin Microbiol. 1980 Nov;12(5):651–655. doi: 10.1128/jcm.12.5.651-655.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Schuchter L. M., Wingard J. R., Piantadosi S., Burns W. H., Santos G. W., Saral R. Herpes zoster infection after autologous bone marrow transplantation. Blood. 1989 Sep;74(4):1424–1427. [PubMed] [Google Scholar]
  19. Solomon A. R., Rasmussen J. E., Weiss J. S. A comparison of the Tzanck smear and viral isolation in varicella and herpes zoster. Arch Dermatol. 1986 Mar;122(3):282–285. [PubMed] [Google Scholar]
  20. Vreeswijk J., Folkers E., Wagenaar F., Kapsenberg J. G. The use of colloidal gold immunoelectron microscopy to diagnose varicella-zoster virus (VZV) infections by rapid discrimination between VZV, HSV-1 and HSV-2. J Virol Methods. 1988 Dec;22(2-3):255–271. doi: 10.1016/0166-0934(88)90108-5. [DOI] [PubMed] [Google Scholar]
  21. WILLIAMS M. G., ALMEIDA J. D., HOWATSON A. F. Electron microscope studies on viral skin lesions. A simple and rapid method of identifying virus particles. Arch Dermatol. 1962 Sep;86:290–297. doi: 10.1001/archderm.1962.01590090032010. [DOI] [PubMed] [Google Scholar]
  22. Weller T. H. Varicella and herpes zoster. Changing concepts of the natural history, control, and importance of a not-so-benign virus. N Engl J Med. 1983 Dec 8;309(23):1434–1440. doi: 10.1056/NEJM198312083092306. [DOI] [PubMed] [Google Scholar]
  23. West P. G., Aldrich B., Hartwig R., Haller G. J. Increased detection rate for varicella-zoster virus with combination of two techniques. J Clin Microbiol. 1988 Dec;26(12):2680–2681. doi: 10.1128/jcm.26.12.2680-2681.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]

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