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Br J Ophthalmol 2004;88:142-144 doi:10.1136/bjo.88.1.142
  • Laboratory science - Scientific reports

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

  1. S Farhatullah1,
  2. S Kaza2,
  3. S Athmanathan1,
  4. P Garg2,
  5. S B Reddy1,
  6. S Sharma1
  1. 1Jhaveri Microbiology Center, Professor Brien Holden Eye Research Center, Hyderabad Eye Research Foundation, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad - 500 034, India
  2. 2Cornea Services, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad - 500 034, India
  1. Correspondence to: Savitri Sharma, MD Jhaveri Microbiology Center, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad - 500 034, India; savitrilvpeye.org
  • Accepted 16 April 2003

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.

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