DETECTION OF VARICELLA-ZOSTER VIRUS-DNA IN PATIENTS WITH ACUTE PERIPHERAL FACIAL PALSY BY THE POLYMERASE CHAIN-REACTION, AND ITS USE FOR EARLY DIAGNOSIS OF ZOSTER SINE HERPETE

Varicella-zoster virus (VZV) reactivation without cutaneous vesicles ( tester sine herpete) has been demonstrated in 8 to 25% of patients wit h acute peripheral facial palsy (APFP) by serological methods. To make an early diagnosis of zoster sine herpete, VZV DNA in oropharyngeal s wabs from patients with APFP was examined by the polymerase chain reac tion (PCR). VZV DNA was detected in oropharyngeal swabs from 6 of 36 ( 17%) patients with APFP by PCR. VZV DNA was detected in the oropharyng eal swabs from the six patients at their initial visit (2 to 4 days af ter the onset of APFP), while the anti-VZV IgM and IgG antibody titers were not increased significantly. In contrast, VZV DNA was undetectab le in the oropharyngeal swabs at the time when the VZV specific antibo dy response appeared. These results indicate that detection of VZV DNA in oropharyngeal swabs by PCR is more useful than currently available serological assays for the early diagnosis of tester sine herpete in patients with APFP. (C) 1997 Wiley-Liss, Inc.