TY - JOUR
T1 - Laboratory results in ocular viral diseases
T2 - Implications in clinical-laboratory correlation
AU - Marangon, Fabiana Bogossian
AU - Miller, Darlene
AU - Alfonso, Eduardo
PY - 2007
Y1 - 2007
N2 - Purpose: To document etiology and predictive value of clinical diagnosis in laboratory confirmed viral diseases. Methods: Reports of culture-positive cases of samples collected from patients presenting from January 1987 - December 2001 were evaluated. Results: One: thousand nine hundred and sixty-four (1964) cultures were submitted during 1987-2001. Twenty-six percent were positive (514). Human herpesvirus 1 was the mostfrequent agent isolated from all positive culture (56%). Adenovirus was the most common virus isolated from conjunctiva (66%), human herpesvirus 1 from lid and cornea (76%, 88%) and cytomegalovirus from vitreous (27%). Some unusual pathogens were recovered from conjunctiva as cytomegalovirus and from cornea as adenovirus, enterovirus and cytomegalovirus. Recognition of common viral syndromes was human herpesvirus 1 (88%), epidemic keratoconjunctivitis (88%), acute hemorrhagic conjunctivitis (70%) and varicella zoster virus (100%). However, some misdiagnosed cases were observed. Thirteen percent of conjunctivitis thought to be caused by herpes were due to adenovirus, 3.2% to Enterovirus, 3.2% to varicella zoster virus and 3.2% to human cytomegalovirus. Also, 5% of cases with a clinical diagnosis of herpes keratitis were caused by adenovirus and 2.7% by enterovirus. Finally, 4.8% of cases thought to be adenovirus conjunctivitis were herpes conjunctivitis. Conclusions: Human herpesvirus 1 remains the most frequently isolated virus from ocular sites in general (56%). Nonherpetic corneal isolates were in decreasing order: adenovirus, enterovirus and cytomegalovirus. Clinical and laboratory correlation was less than 90%. The most misdiagnosed cases were herpes conjunctivitis and keratitis, some cases of adenovirus conjunctivitis some cases of acute hemorrhagic conjunctivitis. It is essential that a rapid and specific diagnosis is offered under atypical viral presentation for the institution of specific antiviral therapy and to avoid complications that can be a result of misdiagnosis and inappropriate treatment. Also it is important to do viral testing in order to confirm clinical diagnosis, report emerging infections, resistance and change in the epidemiology.
AB - Purpose: To document etiology and predictive value of clinical diagnosis in laboratory confirmed viral diseases. Methods: Reports of culture-positive cases of samples collected from patients presenting from January 1987 - December 2001 were evaluated. Results: One: thousand nine hundred and sixty-four (1964) cultures were submitted during 1987-2001. Twenty-six percent were positive (514). Human herpesvirus 1 was the mostfrequent agent isolated from all positive culture (56%). Adenovirus was the most common virus isolated from conjunctiva (66%), human herpesvirus 1 from lid and cornea (76%, 88%) and cytomegalovirus from vitreous (27%). Some unusual pathogens were recovered from conjunctiva as cytomegalovirus and from cornea as adenovirus, enterovirus and cytomegalovirus. Recognition of common viral syndromes was human herpesvirus 1 (88%), epidemic keratoconjunctivitis (88%), acute hemorrhagic conjunctivitis (70%) and varicella zoster virus (100%). However, some misdiagnosed cases were observed. Thirteen percent of conjunctivitis thought to be caused by herpes were due to adenovirus, 3.2% to Enterovirus, 3.2% to varicella zoster virus and 3.2% to human cytomegalovirus. Also, 5% of cases with a clinical diagnosis of herpes keratitis were caused by adenovirus and 2.7% by enterovirus. Finally, 4.8% of cases thought to be adenovirus conjunctivitis were herpes conjunctivitis. Conclusions: Human herpesvirus 1 remains the most frequently isolated virus from ocular sites in general (56%). Nonherpetic corneal isolates were in decreasing order: adenovirus, enterovirus and cytomegalovirus. Clinical and laboratory correlation was less than 90%. The most misdiagnosed cases were herpes conjunctivitis and keratitis, some cases of adenovirus conjunctivitis some cases of acute hemorrhagic conjunctivitis. It is essential that a rapid and specific diagnosis is offered under atypical viral presentation for the institution of specific antiviral therapy and to avoid complications that can be a result of misdiagnosis and inappropriate treatment. Also it is important to do viral testing in order to confirm clinical diagnosis, report emerging infections, resistance and change in the epidemiology.
KW - Eye infections
KW - Herpetic/diagnosis
KW - Keratitis
KW - Polymerase chain reaction
KW - Sensitivity and specificity
KW - Simplexvirus/isolation & purification
KW - Viral/diagnosis
KW - Viral/etiology
UR - http://www.scopus.com/inward/record.url?scp=34249937415&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34249937415&partnerID=8YFLogxK
U2 - 10.1590/S0004-27492007000200002
DO - 10.1590/S0004-27492007000200002
M3 - Article
C2 - 17589685
AN - SCOPUS:34249937415
VL - 70
SP - 189
EP - 194
JO - Arquivos Brasileiros de Oftalmologia
JF - Arquivos Brasileiros de Oftalmologia
SN - 0004-2749
IS - 2
ER -