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| ===Molecular Methods=== | | ===Molecular Methods=== |
| *====Polymerase chain reaction (PCR)====
| | ====Polymerase chain reaction (PCR)==== |
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| *Confirmation of monkeypox virus (MPXV) infection is based on nucleic acid amplification testing, using real-time or conventional PCR, for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing. | | *Confirmation of monkeypox virus (MPXV) infection is based on nucleic acid amplification testing, using real-time or conventional PCR, for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing. |
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| *[[Virus|Viral]] detection is done by finding [[Varicella zoster virus|VZV]] in a [[blood]], [[vesicle]] [[fluid]], or [[tissue]] sample. Detection is done by culturing the [[virus]] or by detecting its [[genetic material]] ([[Varicella zoster virus|VZV]] [[DNA]]). | | *[[Virus|Viral]] detection is done by finding [[Varicella zoster virus|VZV]] in a [[blood]], [[vesicle]] [[fluid]], or [[tissue]] sample. Detection is done by culturing the [[virus]] or by detecting its [[genetic material]] ([[Varicella zoster virus|VZV]] [[DNA]]). |
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| ===VZV DNA testing===
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| *[[Varicella zoster virus|VZV]] [[DNA]] testing is [[Sensitivity (tests)|sensitive]] and measures [[viral load]].
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| ===Direct Fluorescent Antibody (DFA)===
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| *[[Direct fluorescent antibody|DFA]] test detects the presence of [[Varicella zoster virus|VZV]] in the cells in the [[skin]] lesion using a labeled [[antibody]]. It is rapid but less [[Specificity (tests)|specific]] and [[Sensitivity (tests)|sensitive]] than [[DNA]] testing.
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| ===VZV culture===
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| *[[Culture medium|Culture]] is not very reliable for [[Varicella zoster virus|VZV]] and can lead to [[false-negative]] results.
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| ===Microscopic Findings===
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| <gallery>
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| File:Chickenpox37.jpeg| Photomicrograph reveals the intranuclear inclusions produced by varicella virus grown in a tissue culture (500x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox14.jpeg|Cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox (125x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox13.jpeg|Hematoxylin-eosin (H&E)-stained photomicrograph reveals some of the cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox, or varicella zoster virus lesion (125x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox12.jpeg|Photomicrograph reveals some of the cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox, or varicella zoster virus lesion (500x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox11.jpeg|Hematoxylin-eosin (H&E)-stained photomicrograph reveals some of the cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox, or varicella zoster virus lesion (50x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox10.jpeg|Hematoxylin-eosin (H&E)-stained photomicrograph reveals some of the cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox, or varicella zoster virus lesion (50x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox09.jpeg|Photomicrograph reveals some of the cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox, or varicella zoster virus lesion (500x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox08.jpeg|Photomicrograph reveals some of the cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox, or varicella zoster virus lesion (1200x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| File:Chickenpox07.jpeg|Photomicrograph reveals some of the cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox, or varicella zoster virus lesion (1200x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL"> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| </gallery>
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| ==References== | | ==References== |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Bassel Almarie, M.D.
Overview
The laboratory findings of chickenpox include blood tests that can be done to identify the response to acute infection (IgM) or previous infection and subsequent immunity (IgG). Prenatal diagnosis of fetal varicella infection can be performed using ultrasound at 5 weeks following primary maternal infection. A PCR test of the mother's amniotic fluid can also be performed, though the risk of spontaneous abortion due to the amniocentesis procedure is higher than the risk of the baby developing fetal varicella syndrome.
Laboratory Findings
Molecular Methods
Polymerase chain reaction (PCR)
- Confirmation of monkeypox virus (MPXV) infection is based on nucleic acid amplification testing, using real-time or conventional PCR, for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing.
- PCR kits detecting MPXV are under development but no commercial validated PCR kits are currently available widely.
- DNA can be extracted from samples using any standard extraction protocols or kits.
- Sample lysis in DNA extraction inactivates live virus. Therefore, sample lysis should be performed under a biosafety cabinet.
- For crust samples, DNA extraction kit for tissue samples should be used to insure appropriate sample lysis.
Molecular detection
References
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