Chickenpox laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
The laboratory findings of chickenpox include: Blood tests 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 (DNA) 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
Laboratory tests useful for the diagnosis of chickenpox include:
- PCR done by collecting skin vesicles fluid, scabs, saliva and cerebrospinal fluid if neurological symptoms or signs are present. [1]
- PCR along with restriction enzyme digest and sequencing of specific segments of the viral genome can be used to determine whether VZV is resistant to acyclovir.[1]
- Antibody Testing
- Viral detection
- VZV DNA testing
- Direct Fluorescent Antibody (DFA)
- VZV culture
Antibody Testing
- Laboratory tests detect and measure the level of VZV antibodies, presence of IgM antibodies indicates acute infection.
IgM
- It can be detected within a week or two post exposure.
- The levels of IgM antibodies rises for a short period of time and then falls below detectable levels.
- Post-Infection, the IgM levels rise only when the latent VZV is reactivated.
IgG
- IgG antibodies are produced several weeks after the initial exposure.
- IgG levels rise during active infection and then the levels become stable as the VZV infection gets resolves and as the virus gets inactivated.
Viral detection
- Viral detection is done by finding VZV in a blood, vesicle fluid, or tissue sample. Detection done by culturing the virus or by detecting it's genetic material (VZV DNA).
VZV DNA testing
- VZV DNA testing is sensitive and measures viral load.
Direct Fluorescent Antibody (DFA)
- DFA test visualizes the presence of VZV in the cells in the skin lesion using a labeled antibody. It is rapid, but less specific and sensitive than DNA testing.
VZV culture
- Culture is not very reliable for VZV and can lead to false-negative results.
Microscopic Findings
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![Photomicrograph reveals the intranuclear inclusions produced by varicella virus grown in a tissue culture (500x mag). From Public Health Image Library (PHIL). [2]](/images/1/18/Chickenpox37.jpeg)
Photomicrograph reveals the intranuclear inclusions produced by varicella virus grown in a tissue culture (500x mag). From Public Health Image Library (PHIL). [2]
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![Cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox (125x mag). From Public Health Image Library (PHIL). [2]](/images/2/2d/Chickenpox14.jpeg)
Cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox (125x mag). From Public Health Image Library (PHIL). [2]
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![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). From Public Health Image Library (PHIL). [2]](/images/b/b6/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). From Public Health Image Library (PHIL). [2]
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![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). From Public Health Image Library (PHIL). [2]](/images/3/38/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). From Public Health Image Library (PHIL). [2]
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![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). From Public Health Image Library (PHIL). [2]](/images/a/a8/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). From Public Health Image Library (PHIL). [2]
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![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). From Public Health Image Library (PHIL). [2]](/images/e/eb/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). From Public Health Image Library (PHIL). [2]
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![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). From Public Health Image Library (PHIL). [2]](/images/8/81/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). From Public Health Image Library (PHIL). [2]
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![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). From Public Health Image Library (PHIL). [2]](/images/6/63/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). From Public Health Image Library (PHIL). [2]
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![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). From Public Health Image Library (PHIL). [2]](/images/5/5b/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). From Public Health Image Library (PHIL). [2]
![Photomicrograph reveals the intranuclear inclusions produced by varicella virus grown in a tissue culture (500x mag). From Public Health Image Library (PHIL). [2]](/index.php/File:Chickenpox37.jpeg)
![Cytoarchitectural histopathologic changes which you’d find in a human skin tissue specimen that included a chickenpox (125x mag). From Public Health Image Library (PHIL). [2]](/index.php/File:Chickenpox14.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). From Public Health Image Library (PHIL). [2]](/index.php/File:Chickenpox13.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). From Public Health Image Library (PHIL). [2]](/index.php/File:Chickenpox12.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). From Public Health Image Library (PHIL). [2]](/index.php/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). From Public Health Image Library (PHIL). [2]](/index.php/File:Chickenpox10.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). From Public Health Image Library (PHIL). [2]](/index.php/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 (1200x mag). From Public Health Image Library (PHIL). [2]](/index.php/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). From Public Health Image Library (PHIL). [2]](/index.php/File:Chickenpox07.jpeg)