AI Article Synopsis
- Laboratory confirmation through PCR testing is essential for diagnosing and managing herpes simplex virus (HSV) keratitis, though previous sensitivity rates were low.
- An educational intervention targeting swab technique for sample collection was implemented, leading to a retrospective review of keratitis cases before and after the program.
- The findings showed a significant increase in lab-confirmed HSV diagnoses post-intervention, indicating that improved swabbing techniques enhanced the sensitivity of PCR testing for HSV-1 in keratitis.
Article Abstract
Background: Laboratory confirmation is crucial for diagnosis and management of herpes simplex virus (HSV) keratitis. However, the sensitivity of polymerase chain reaction (PCR) in keratitis is low (25%) compared with that of mucocutaneous disease (75%). We developed an educational intervention aimed at improving the diagnostic yield of PCR.
Methods: The medical records of keratitis cases seen at the emergency department of a London tertiary ophthalmic referral hospital over two distinct periods, before and after an educational program on swab technique, were reviewed retrospectively.
Results: A total of 252 HSV cases were included. Increases in the laboratory-confirmed diagnosis of HSV-1 were observed, in both first presentations (11.1%-57.7%) and recurrent cases (20%-57.6%). The rate of positive HSV-1 PCR in eyes with an epithelial defect increased from 19% pre-intervention to 62% post intervention. Notably, 3% were positive for varicella zoster virus DNA, and there was a single case of keratitis.
Conclusion: Our results suggest that, with proper swabbing technique, PCR may be more sensitive than previously reported.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001569 | PMC |
| http://dx.doi.org/10.5693/djo.01.2024.01.002 | DOI Listing |
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