Department of Otorhinolaryngology, Eulji University Hospital, Eulji University, Daejeon, Republic of Korea.
Department of Medical Science, Chungnam National University, Daejeon, Korea.
J Med Virol. 2018 May;90(5):959-964. doi: 10.1002/jmv.25030. Epub 2018 Feb 15.
Infection caused by Varicella zoster virus (VZV) is a common etiology of acute peripheral facial palsy (APFP). We aimed to assess the clinical significance of detecting VZV DNA from the saliva of patients with APFP. Saliva collected from 36 patients with unilateral APFP at initial visit was analyzed to detect VZV DNA by polymerase chain reaction. The House-Brackmann (HB) scale was used to evaluate FP severity on admission day, at week 2, and at weeks 10-12 after start of treatment. Among the 28 patients without rash, VZV DNA was detected in 3 patients (10.7%); 6 of 8 patients (75.0%) with rash showed VZV DNA (P = 0.001). VZV DNA-positive patients had worse hearing than VZV DNA-negative patients (P < 0.05). A significantly higher proportion of VZV DNA-negative patients (96.3%) showed complete recovery than VZV DNA-positive patients (55.6%) (P = 0.006). In conclusion, VZV DNA-positive patients had worse hearing and incomplete recovery compared to VZV DNA-negative patients, irrespective of the presence of rash. Tests for the detection of VZV DNA in saliva may be helpful for early differential diagnosis and choosing an appropriate medical treatment of APFP.
水痘带状疱疹病毒（VZV）感染是急性周围性面瘫（APFP）的常见病因。我们旨在评估从 APFP 患者唾液中检测 VZV DNA 的临床意义。采集 36 例单侧 APFP 患者初诊时的唾液，通过聚合酶链反应（PCR）检测 VZV DNA。在入院当天、第 2 周以及治疗开始后第 10-12 周，采用 House-Brackmann（HB）量表评估 FP 严重程度。在 28 例无皮疹的患者中，有 3 例（10.7%）检测到 VZV DNA；8 例有皮疹的患者中有 6 例（75.0%）检测到 VZV DNA（P=0.001）。VZV DNA 阳性患者的听力较 VZV DNA 阴性患者差（P<0.05）。VZV DNA 阴性患者（96.3%）完全恢复的比例明显高于 VZV DNA 阳性患者（55.6%）（P=0.006）。总之，无论是否有皮疹，VZV DNA 阳性患者的听力较差且恢复不完全，而 VZV DNA 阴性患者则恢复较好。检测唾液中的 VZV DNA 可能有助于早期鉴别诊断和选择合适的 APFP 治疗方法。
