Document Detail


Herpes simplex keratitis in South India: clinico-virological correlation.
MedLine Citation:
PMID:  10482477     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: A retrospective cross-section study to analyze the prevalence of herpes simplex virus-induced keratitis (HSK) among 3,000 patients attending a corneal clinic in South India between 1995 and 1997, and to evaluate laboratory techniques for detecting HSK. METHODS: The clinico-virological correlation was studied using herpes simplex virus (HSV) isolation on the Vero cell line, HSV-specific antigen detection by indirect immunofluorescence (IF) microscopy, and serum anti-HSV IgG quantitation, IgM estimation, and tear secretory IgA (sIgA) detection by ELISA. OBSERVATIONS: HSK had a prevalence of 7.8% (234 patients) in this study. A virological correlation could be obtained in 44.4% of the cases that had epithelial manifestations and in 14.8% of the cases that had only stromal disease. In 161 cases where both culture and IF microscopy were used, IF detected 27 cases (26.8%) more than cell culture. The difference in sensitivity between cell culture and IF was found to be statistically significant (McNemar's test, P < .05). An elevation in IgG titer was seen in 17 (30.4%) cases. IgM was detected in only 2 cases of the 62 (3.2%) analyzed. Of the 138 cases analyzed, sIgA was positive in 28 (20.3%) cases. A proved diagnosis could be made in 58% of cases when the specimen was collected during the first week after disease onset, and in only 5% when the time interval increased to 4 weeks. CONCLUSIONS: HSV antigen detection by indirect IF is a rapid and sensitive diagnostic tool for HSK. Tear secretory IgA (sIgA) is a specific marker for acute herpetic keratitis, and the detection of HSV-specific tear sIgA is a valuable adjunct to virus isolation and antigen detection in the laboratory diagnosis of HSK. For a successful diagnosis, the specimen should be collected as soon as possible after HSK onset.
Authors:
N P Pramod; P Rajendran; K A Kannan; S P Thyagarajan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Japanese journal of ophthalmology     Volume:  43     ISSN:  0021-5155     ISO Abbreviation:  Jpn. J. Ophthalmol.     Publication Date:    1999 Jul-Aug
Date Detail:
Created Date:  1999-09-29     Completed Date:  1999-09-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0044652     Medline TA:  Jpn J Ophthalmol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  303-7     Citation Subset:  IM    
Affiliation:
Department of Microbiology, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Animals
Antibodies, Viral / analysis
Antigens, Viral / analysis
Cercopithecus aethiops
Child
Child, Preschool
Cornea / virology*
Cross-Sectional Studies
Female
Fluorescent Antibody Technique, Indirect
Herpesvirus 1, Human / immunology,  isolation & purification
Humans
Immunoglobulin A, Secretory / analysis
India / epidemiology
Infant
Keratitis, Herpetic / diagnosis,  epidemiology*
Male
Middle Aged
Prevalence
Retrospective Studies
Tears / immunology
Vero Cells / microbiology
Virus Cultivation
Chemical
Reg. No./Substance:
0/Antibodies, Viral; 0/Antigens, Viral; 0/Immunoglobulin A, Secretory

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