Safrin S, Shaw H, Bolan G, Cuan J, Chiang C S
Department of Medicine, University of California, San Francisco, USA.
Sex Transm Dis. 1997 Mar;24(3):176-80. doi: 10.1097/00007435-199703000-00010.
The diagnosis of mucocutaneous herpes simplex virus (HSV) is hampered by suboptimal sensitivity of virus culture and atypical clinical morphology.
To compare the diagnostic usefulness of the polymerase chain reaction (PCR) and virus culture.
Consecutive samples from 246 patients at an urban sexually transmitted diseases clinic were tested for HSV by both PCR and virus culture.
Only 59% of HSV-positive samples were correctly diagnosed by the clinician; 11% had an atypical appearance. HSV-positive lesions were more often vesiculoulcerative or crusted than HSV-negative lesions, and of shorter median duration. Thirty-one samples were PCR positive and virus culture negative; these were often from crusted or older lesions. However, PCR was negative in 27 instances in which HSV was diagnosed clinically, of which 2 were vesicular and 15 ulcerative.
HSV PCR is more rapid and sensitive than virus culture for diagnosis of mucocutaneous lesions. The data suggesting that PCR may be suboptimally sensitive need to be further investigated.
病毒培养的敏感性欠佳以及临床形态不典型妨碍了黏膜皮肤单纯疱疹病毒（HSV）的诊断。
比较聚合酶链反应（PCR）与病毒培养的诊断效用。
对一家城市性传播疾病诊所的246例患者的连续样本同时进行PCR和病毒培养以检测HSV。
临床医生仅正确诊断出59%的HSV阳性样本；11%外观不典型。HSV阳性皮损比HSV阴性皮损更常表现为水疱溃疡性或结痂性，且中位持续时间更短。31个样本PCR阳性但病毒培养阴性；这些样本通常来自结痂或较陈旧的皮损。然而，在临床诊断为HSV的27例病例中PCR呈阴性，其中2例为水疱性，15例为溃疡性。
对于黏膜皮肤损害的诊断，HSV PCR比病毒培养更快速、敏感。提示PCR敏感性可能欠佳的数据有待进一步研究。
