This study compared viral culture with routine cytology and immunofluorescent staining of oral epithelial cell smears for the diagnosis of orofacial infections due to herpes simplex virus (HSV) or herpes zoster (HZ). Twenty-one patients were studied. Viral culture gave the greatest number of positive results, with an assumed sensitivity and specificity of 100%, but the test took at least 24 hours. For haematoxylin and eosin cytology, the corresponding figures for sensitivity and specificity were 54% and 100%, respectively. Direct staining of epithelial smears with FITC-conjugated monoclonal antibodies to HSV type 1, HSV type 2 and HZ had a sensitivity of 82% and specificity of 71%. Smears prepared from oral washings, and stained with the same fluorescent antibodies, yielded a sensitivity of 83% and specificity of 86%. To allow rapid diagnosis, oral epithelial smears for immunofluorescent examination should also be prepared, since in more than 80% of cases such smears will confirm an herpetic infection in less than one hour.
Adult Aged