Diagnostic Methods and Management Strategies of Herpes Simplex and Herpes Zoster Infections

Frisch, Stephanie; Guo, Aibing Mary

doi:10.1016/j.cger.2013.01.003

Cited by 13 publications

(16 citation statements)

References 115 publications

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“…Although this test is easy to perform, rapid and cheap, its sensitivity is limited (only 40%-50% in comparison with cell cultures) [422,427] . It is also influenced by the stage of the lesion as it is more sensitive to material taken from fresh vesicles rather than from pustules or scabs [421,428] and, above all, cannot distinguish the lesions caused by HSV and those caused by VZV [429] .…”

Section: Tzanck Smear Testsmentioning

confidence: 99%

“…Furthermore, they can be automated tests and used on a wide variety of materials. They are more sensitive than viral cultures, DFA and Tzanck smears particularly when primers for genes 28 and 29 are used [30,428,429,440,449,450,457] . Molecular biology tests are also useful in the case of varicella appearing 7-42 d after vaccination, in the case of herpes zoster appearing 42 d after vaccination and, in the case of the suspected transmission of the vaccine virus, can distinguish virus vaccine, wild-type virus and potential recombinants of vaccine and wild-type viruses [30,451,452,454,455,[458][459][460][461][462][463] , although some tests have proved to be less appropriate over time for these purposes [30] .…”

Section: Direct Fluorescent Antibody Assaymentioning

confidence: 99%

“…The monoclonal antibodies of choice are those against cell membrane-associated viral antigens [446] . The assay is highly specific and more sensitive than Tzanck smears or viral cultures [423,434,448] , and as specific as but less sensitive (73.6%-86%) than molecular biology tests [348,428] , although it can be used if molecular biology tests are not available [5] . It is also rapid (about two hours), but it needs special equipment that mean it can only be used in limited areas [348,349] , and requires material collected from the skin lesions, which have to be swabbed in order to avoid any bleeding (any antibodies present in the blood can stop the reaction and lead to false negative results) [30] .…”

Section: Direct Fluorescent Antibody Assaymentioning

confidence: 99%

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Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn. Core tip: Although varicella during pregnancy is infrequent and congenital varicella syndrome (CVS) is rare, every available means should be used to prevent and diagnose them. Microbiology laboratories can be crucial in these situations: Evaluating a mother's immune status with sensitive and specific tests for the detection of antibodies; allowing a rapid diagnosis with molecular biology tests when a clinical manifestation may be due to different etiologies; following pregnant women with varicella for the prenatal diagnosis of CVS with close collaboration between molecular biology investigators and specialists in imaging diagnostics.De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World

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Section: Tzanck Smear Testsmentioning

confidence: 99%

Section: Direct Fluorescent Antibody Assaymentioning

confidence: 99%

Section: Direct Fluorescent Antibody Assaymentioning

confidence: 99%

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Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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“…Traditional laboratory methods for the diagnosis of cutaneous and mucocutaneous HSV-1, HSV-2, and VZV infections include the Tzanck smear, direct fluorescent assay (DFA), and cell culture (including shell vial culture) (3). Several reports have been published on the increased sensitivity of real-time PCR assays for detecting HSV/VZV over the traditional methods described above (5-7).…”

mentioning

confidence: 99%

“…Due to the similarities in the clinical presentations of infections caused by these three herpesviruses, a clinical diagnosis needs to be confirmed by laboratory testing to prevent misdiagnosis (2). The need for accurate and specific laboratory diagnostics is especially important in immunocompromised patients who may present with atypical lesions confounding the clinical diagnosis and delaying the institution of appropriate antiviral therapy (1,3,4). Consequently, etiologic diagnosis and differentiation of HSV-1, HSV-2, and VZV infections is critical for both patient care and infection control (3,4).…”

mentioning

confidence: 99%

Clinical Validation of the Lyra Direct HSV 1+2/VZV Assay for Simultaneous Detection and Differentiation of Three Herpesviruses in Cutaneous and Mucocutaneous Lesions

et al. 2014

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We evaluated the Lyra Direct HSV 1؉2/VZV multiplex real-time PCR assay for the detection and differentiation of herpes simplex virus 1 (HSV-1), HSV-2, and varicella-zoster virus (VZV) on 695 consecutive cutaneous and mucocutaneous lesion specimens. The intra-assay and interassay coefficient of variation values for the Lyra assay were 0.29 to 1.30% and 2.33 to 2.61%, respectively. The sensitivities, specificities, and positive and negative predictive values were 93.4 to 95.0%, 96.1 to 96.8%, 78.0 to 80.3%, and 99.0 to 99.1%, respectively, in comparison to those of viral culture. The values were further improved when a resolution analysis was performed with a laboratory-developed PCR assay. Herpes simplex virus 1 and 2 (HSV-1 and HSV-2, respectively) and varicella-zoster virus (VZV) cause serious cutaneous and mucocutaneous lesions at every stage in immunocompromised patients (1). Due to the similarities in the clinical presentations of infections caused by these three herpesviruses, a clinical diagnosis needs to be confirmed by laboratory testing to prevent misdiagnosis (2). The need for accurate and specific laboratory diagnostics is especially important in immunocompromised patients who may present with atypical lesions confounding the clinical diagnosis and delaying the institution of appropriate antiviral therapy (1, 3, 4). Consequently, etiologic diagnosis and differentiation of HSV-1, HSV-2, and VZV infections is critical for both patient care and infection control (3, 4).Traditional laboratory methods for the diagnosis of cutaneous and mucocutaneous HSV-1, HSV-2, and VZV infections include the Tzanck smear, direct fluorescent assay (DFA), and cell culture (including shell vial culture) (3). Several reports have been published on the increased sensitivity of real-time PCR assays for detecting HSV/VZV over the traditional methods described above (5-7). Most published molecular assays utilize separate reactions for either HSV or VZV, and limited multiplex formats for the simultaneous detection and differentiation of HSV-1, HSV-2, and VZV have been reported (7-9). Currently, four molecular assays have been cleared by the Food and Drug Administration (FDA) for the detection and/or typing of HSV-1 and HSV-2 in genital and/or oral lesions: the MultiCode HSV-1&2 assay (Luminex Corporation, Austin, TX), the ProbeTec HSV QX amplified DNA assay (BD Diagnostics, Sparks, MD), the IsoAmp HSV assay (BioHelix Corporation, Beverly, MA), and the AmpliVue HSV 1ϩ2 assay (Quidel Corporation, San Diego, CA) (10).(This study was presented in part at the 114th Annual Meeting of the American Society for Microbiology, Boston, MA, 17 to 20 May 2014.)In May 2014, the FDA cleared the Lyra Direct HSV 1ϩ2/VZV assay (Quidel Corporation, San Diego, CA). This is the first FDAcleared commercial multiplex real-time PCR assay that simultaneously detects and differentiates HSV-1/2 and VZV DNA in both cutaneous and mucocutaneous lesion specimens. The objectives of this preclinical study were to validate the performance of the Lyra assay on cuta...

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Detection of herpes simplex and varicella-zoster virus from skin lesions: comparison of RT-PCR and isothermal amplification for rapid identification

Jevšnik

Lusa²,

Uršič

et al. 2020

Diagnostic Microbiology and Infectious Disease

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Diagnostic Methods and Management Strategies of Herpes Simplex and Herpes Zoster Infections

Cited by 13 publications

References 115 publications

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Clinical Validation of the Lyra Direct HSV 1+2/VZV Assay for Simultaneous Detection and Differentiation of Three Herpesviruses in Cutaneous and Mucocutaneous Lesions

Detection of herpes simplex and varicella-zoster virus from skin lesions: comparison of RT-PCR and isothermal amplification for rapid identification

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