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Diseases like viral keratitis can harm corneal nerves, which are necessary for maintaining the health and functionality of the cornea. Recent research has shown that corneal nerve pathology affects the infected eye as well as the contralateral one, and that aberrant changes in sympathetic nerves can be seen, with the exception of sensory nerves that correspond to corneal sensation. However, apart from in vivo confocal microscopy and corneal sensation, there have been no additional prognostic indicators that allow clinicians to assess the severity of corneal nerve damage. While multiple functions of corneal nerves are mediated by neuropeptides, substance P, the first topical neuropeptide used in ocular clinical practice, was proved to regulate the process of viral infections, and it is involved in bilateral corneal pathologies through pro-inflammatory and neurotrophic functions in viral keratitis, so it may be used as a diagnostic biomarker or a therapeutic target. Therefore, this review summarized the changes and roles of corneal nerves as well as substance P in viral keratitis, which may serve as a reference for further study into associated mechanisms and clinical applications.
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Objective:To observe the clinical efficacy of modified Yihuo Qnggan Tuiyi Tang on herpes simplex keratitis with liver meridian and wind-heat，so as to explore its mechanism of action. Method:Totally 130 patients with herpes simplex keratitis with liver meridian and wind-heat were randomly divided into control group and observation group，with 65 cases in each group. The control group was treated with conventional western medicine，while the observation group was treated with modified Yihuo Qinggan Tuiyi Tang in addition to the therapy of the control group for 4 weeks. The clinical efficacy，traditional Chinese medicine（TCM） syndrome score，symptoms and signs，adverse reactions and recurrence rate of the two groups were compared. The levels of serum interferon gamma（IFN-γ），interleukin-6（IL-6），interleukin-8（IL-8） inflammatory factors，malondialdehyde (MDA)，antioxidant activity (TAC)，glutathione peroxidase（GSH-PX）of oxidative stress indexes were detected by enzyme linked immunosorbent assay （ELISA）. The levels of CD4+ and CD8+ were measured by flow cytometry. The recurrence rate was observed during 1-year follow-up visit. Result:The total effective rate of observation group was better than that of control group (Z=2.161，P<0.05). After treatment，the scores of eye pain，shame，photophobia，tears，vision loss，redness and total eyelid swelling were significantly lower than those of control group (P<0.05). The total effective rate of TCM syndrome in the observation group was better than that of control group (Z=2.540，P<0.05). After treatment，the scores of pain，eyelid redness，conjunctival congestion，corneal punctate pannus，corneal pannus and corneal pannus depth of symptoms and signs in observation group were better than those of control group (P<0.05). The level of serum IFN-γ in observation group was higher than that of control group，and the levels of IL-6 and IL-8 were lower than those of control group (P<0.05). Levels of MDA in the observation group was higher than that of control group (P<0.05). The levels of CD4+and CD4+/CD8+ in observation group were higher than those of control group，and the levels of CD8+ were lower than that of control group (P<0.05). The recurrence rate in observation group was significantly lower than that in control group after withdrawal for 6 months and 12 months (P<0.05). Conclusion:In addition to the therapy of routine western medicine， modified Yihuo Qinggan Tuiyi Tang has a good clinical efficacy in treating herpes simplex keratitis with liver meridian and wind-heat，and can reduce the scores of TCM syndromes，alleviate symptoms and signs，and reduce the recurrence rate. Its mechanism may be related to reducing inflammation reaction，and improving oxidative stress index and immune function.
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Botulinum toxin A (BTA) injections into lacrimal gland are being used for refractory epiphora due to intractable lacrimal disorders with success rates reported from 18% to 86%. Most common side effects are transient ptosis and diplopia. We report a case of a 59-year-old female injected with 2.5 units of BTA injection in each lacrimal gland for functional epiphora. The patient had a history of herpes simplex viral keratitis that was quiescent for more than 2 years. After 3 weeks, she developed reactivation of viral keratitis bilaterally, which was successfully managed with antivirals and topical steroids. Reactivation of quiescent herpes simplex keratitis is a possibility after lacrimal gland BTA and caution should be exercised in such cases.
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·AIM: To evaluate the efficacy and safety of ganciclovir combined with traditional Chinese medicine ( TCM ) in treatment of herpes simplex keratitis (HSK). ·METHODS: All randomized controlled trials ( RCTs) of ganciclovir combined with TCM for HSK were searched in CNKI, VIP, Wanfang, PubMed, Cochrane Library and EMbase database. The clinical endpoints of the total effective rate, relapse rate, heal time, and adverse reaction rate were collected to assess the drugs' efficacy and safety. The improved Jadad Scale was used to evaluate the methodological quality of included literatures. The RevMan5. 3 software and Stata 12. 0 were applied for meta-analysis. ·RESULTS: We finally included 15 RCTs involving 1 285 patients. As for the total effective rate, relapse rate and heal time, significant differences were noted between ganciclovir combined with TCM group and ganciclovir alone group. For the total effective rate, RR and 95% CI were 1. 23 ( 1. 15 ~ 1. 31 ) according to the number of patients and 1. 18(1. 02-1. 38) according to the number of diseased eyes. For relapse rate, RR and 95% CI were 0. 25 (0. 17-0. 36). For heal time, MD and 95% CI were -7. 58 (-10. 89 to - 4. 26 ). No statistic difference of adverse reaction rate between the two groups was observed [RR=0.53, 95% CI(0. 23-1. 22)]. The side effects in the two groups were mild and could be relieved by themselves. ·CONCLUSION: The ganciclovir combined with TCM can improve the total efficacy, reduce the relapse rate, and shorten the course of treatment for HSK with good safety.
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@#AIM: To study the clinical effects of ganciclovir eye gel combined with spleen ammonia peptide oral freeze-dried powder in the treatment of epithelial herpes simplex keratitis(HSK).<p>METHODS: Totally 70 cases(70 eyes)with HSK diagnosed in Ophthalmology Department of our hospital from January 2015 to June 2016 were enrolled. All the patients were divided into control group and experimental group randomly. Control group was treated by ganciclovir eye gel, 6 times per day; while experimental group was treated by ganciclovir eye gel combined with spleen ammonia peptide oral freeze-dried powder, administered by cool white boiling water at daily bedtime, 2 milligram of every time. All patients were treated for 30d. Then the therapeutic effects of two groups, including the cure rate, time of corneal ulcer healing, pain relief, photophobia disappeared, vision improvement and recurrence rate were compared and analyzed.<p>RESULTS: The therapeutic effects of experimental group was better than the control group. The cure rate was 80% for experimental group and 51% for control group. The clinical cure rate in experimental group was significantly higher than that of the control group(<i>P</i><0.05). The time for corneal ulcer healing and pain relief and photophobia disappeared in experimental group was significantly shorter than that for the control group(<i>P</i><0.05). The recurrence rate in the 1-year follow-up was 14% for experimental group and 67% for control group. The clinical recurrence rate in experimental group was significantly lower than that of the control group(<i>P</i><0.05).<p>CONCLUSION: The application of ganciclovir eye gel combined with spleen ammonia peptide oral freeze-dried powder in epithelial herpes simplex keratitis, which improves visual acuity, the cure rate and shortens the course of disease and reduces the recurrence rate, is the ideal treatment of epithelial herpes simplex keratitis at present.
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·AIM: To observe the clinical efficacy of Yiqi Yangxue Qufeng therapy ( Heijing Tuiyi Decoction ) in current patients with herpes simplex keratitis.· METHODS: Totally 58 cases with recurrent herpes simplex keratitis patients were selected, then randomly divided into treatment group and control group. Patients in the control group were be treated with recombinant human interferon α - 2b eye drop and ganciclovir ophthalmic gel, patients with iridocyclitis and corneal endothelitis were treated with compound tropicamide eye drops for mydriasis. Fluorometholone eye drops was used to treat eye diseases according to the circumstances, while patients in the treatment group were treated by Heijing Tuiyi Decoction on the basis of the control group. All patients were be treated for 4wk, observed the clinical therapeutic effect and recurrence rate of the disease within 6mo.· RESULTS: There was significant difference in the clinical curative effect and the recurrence rate between the 2 groups (P<0. 05). Compared with before treatment, the CD4+ ratio and CD4+/CD8+ ratio significantly increased after treatment, and significantly higher than that of the control group ( P < 0. 01 ); CD8 + of treatment group significantly decreased and was significantly lower than the control group (P<0. 01).· CONCLUSION: Yiqi Yangxue Qufeng method of traditional Chinese medicine Heijing Tuiyi Decoction combined with conventional antiviral medicine treatment, is better for patients with herpes simplex keratitis, prevent its recurrence, improve clinical efficacy, thereby improves the life quality of patients.
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Objective To observe the clinical effects of fresh amniotic membrane transplantation combined soft corneal contact lens and immunomodulatory therapy on epithelial herpes simplex keratitis (HSK),Methods Together 56 participants with recrudesced epithelial type HSK were incorporated from January of 2012 to January of 2014,and randomly divided into control group and treatment group according to random number table.The treatment group was performed complete removal of corneal lesions with microscope,and then the whole cornea was covered with double fresh amniotic membrane;after the whole limbus was fixed with continuous suturing,the soft contact lenses were worn at the end of the operation.After the operation,Chinese formula,including Yupingfeng particles,ganciclovir ophthalmic gel and oral valacyclovir hydrochloride tablets,was administrated.The control group was treated only with ganciclovir ophthalmic gel and oral valaciclovir hydrochloride tablets,Results In control group,15 patients (53.6％) were cured,6 (21.4％) were markedly improved,2 (7.1％) were effective,5 (17.9％) was invalid,and the overall effective rate was 82.1％,but 6 patients (21.4％) were recrudesced;while in the treatment group,22 patients (78.6％)were cured,6 (21.4％) were markedly improved,and the total effective rate was 100.0％,but 3 patients were recurred.Moreover,the visual acuity were improved about 0.43 visual lines in the control group,and about 2.14 lines in treatment group.Therefore,the curative rate,effective rate and visual improvement of the treatment group was significantly better than those of the control group (all P ＜ 0.05),but the recurrence rate was lower than that of the control group (P ＜ 0.05).Conclusion The comprehensive treatment including fresh anniotic membrane transplantation combined corneal contact lens with Chinese formula were effective for quickly and effectively controlling inflammation,promoting ulcer repair and shortening the course of disease as well as reducing the recurrence.
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OBJECTIVE:To observe the efficacy and safety of fluorometholone combined with ganciclovir in the treatment of herpes simplex keratitis. METHODS:72 patients with herpes simplex keratitis were randomly divided into control group and study group. Control group was treated with 1 drop of 0.15% Ganciclovir ophthalmic gel,4 times every day;shallow-type patients were treated with 0.15% Ganciclovir ophthalmic gel for 2-5 d,then 0.2 g Fluorometholone tablet was orally given when corneal epitheli-al repaired to positive fluorescein staining,3 times a day + 25 mg Indomethacin tablet,orally,3 times a day;deep-type patients were additionally treated with 1 drop of Compound tropicamide eye drop,once every morning and night. Shallow-type patients in study group were treated with 0.15% Ganciclovir ophthalmic gel for 2-5 d,then 1 drop of 0.025% Flumetholon eye drop was giv-en when corneal epithelial repaired to positive fluorescein staining,4 times every day+Indomethacin tablet(the same dose with con-trol group)+Indomethacin tablet(the same dose with control group);deep-type patients were additionally treated Compound tropi-camide eye drop(the same dose with control group). The treatment course for both groups was 7 d. Clinical efficacy,average treat-ment time,recurrence rate and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in study group was significantly higher than control group,average treatment time was significantly shorter than control group,recur-rence rate was significantly lower than control group,the differences were statistically significant(P0.05);the total effective rate for deep-type patients in study group was significantly higher than control group,the difference was statistically significant(P<0.05). There were no obvious adverse reactions during treatment,and liver and kidney function,blood and urine routine showed no abnormality. CON-CLUSIONS:Fluorometholone combined with ganciclovir has significant efficacy in the treatment of herpes simplex keratitis,it can significantly shorten treatment course and reduce recurrence rate,with good safety,especially for deep-type patients.
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AIM: To observe the clinical curative effect of sparse wind clearing heat method combined with western medicine treatment on epithelial herpes simplex keratitis ( HSK) . METHODS: A total of 75 cases ( 75 eyes ) of patients with epithelial HSK were divided into the treatment group 38 cases ( 38 eyes ) and the control group 37 cases ( 37 eyes) . The patients of the control group were treated with ganciclovir drop and symptomatic treatment. On the basis of the above treatment plan, the patients of the treatment group were treated with sparse wind clearing heat decoction. Clinical curative effect was observed and analyzed. RESULTS:In the treatment group, curative rate was 79% and effective rate was 95%. In the control group, curative rate was 54% and effective rate was 78%. The differences had significant difference between the two groups (PCONCLUSION: Sparse wind clearing heat method combined with western medicine treatment on epithelial HSK has preferably curative effect.
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Herpes simplex keratitis (HSK) is the first inflammatory cause for uniocular blindness.The clinical inspection methods commonly used are limited to general observation,while in vivo confocal microscopy (IVCM) can provide details of cellular changes in an intravital HSK.IVCM not only gives more clinical evidence for pathology studying of HSK,but also serves as a new technology for the whole progress of HSK epidemiology.This article reviewed current researches of applying IVCM for HSK clinical observation and summarized these latest results.Morphological changes of each layer of the cornea,the specificity of these changes and clinical application of IVCM had been discussed in this article.
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PURPOSE: To report a case of peripheral ulcerative keratitis in a case of primary herpes simplex infection. CASE SUMMARY: A 7-year-old male complaining of pain, redness, and decreased vision in the left eye 5 days in duration visited our clinic. The patient had also vesicular lesions over the edematous left upper eyelid. Slit-lamp examination revealed peripheral ulcerative keratitis with stromal infiltration involving the superior peripheral cornea. Corneal sensation in the left eye was decreased. The patient was advised to use topical and oral antiviral agents and a topical steroid. After 5 days of follow-up, the corneal lesions were decreased and vesicles were absent. Six months later, only minor opacities remained in the cornea. CONCLUSIONS: We report the first case report in Korea of peripheral ulcerative keratitis with blepharoconjunctivitis presented as primary herpes simplex infection which responded to antiviral and steroid treatment in a young male.
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Child , Humans , Male , Antiviral Agents , Cornea , Corneal Ulcer , Eyelids , Follow-Up Studies , Herpes Simplex , Korea , SensationABSTRACT
AIM: To investigate the clinical effects on the deep lamellar keratoplasty for herpes simplex keratitis. METHODS: Deep lamellar keratoplasty was performed on 105 cases with herpes simplex viral keratitis. All of these patients were followed-up for 12-36mo, the corneal graft transparency, visual acuity and viral keratitis recurrence were observed. RESULTS:Among 24 patients after stripping the corneal stroma which was close to the Descemet's membrane, Central area of 81 cases were about 6mmí6mm of to Descemet's membrane. One hundred and one cases of planting beds were transparent. Visual acuity were improved in varying degrees, best corrected visual acuity was greater than 0. 5 in 67 cases, 0. 3-0. 5 in 35 cases, less than 0. 3 in 3 cases. There was no recurrence of viral keratitis and rejection cases during the observation period. CONCLUSION: Deep lamellar keratoplasty is an effective technique in the treatment of viral keratitis. It is therefore should be an early surgical treatment for frequent episodes of viral keratitis cases.
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Herpes simplex keratitis (HSK),which is caused by infection of herpes simplex virus,is a kind of disease with high incidence and blinding rate.The mechanism of HSK is complex and always attracts the attention of researchers.It is considered as an immune response to viral infection and is related to several factors,such as pathway of infection and immunoregulation.This review reveals the latest advance of the mechanism of HSK in the aspects of viral infection and latency,apoptosis,immunity.
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PURPOSE:To analyze the clinical aspects and risk factors for recurrent herpes simplex keratitis (HSK) after penetrating keratoplasty (PKP). METHODS: Records from 78 eyes of 41 patients who underwent PKP for HSV keratitis with a mean follow-up duration of 31.83+/-21.35 months (24~97 months) were reviewed. The clinical aspects of recurrent keratitis, rejection, and survival rate were evaluated. Previous operation history, preoperative inflammation and neovascularization, graft size, suture methods, and antiviral use were analyzed to elucidate the risk factor for recurrent HSK after PKP. RESULTS: HSK recurred in 47.4% of the patients at a mean time of 18.36+/-21.02 months after PKP. The mean duration of keratitis was 2.16+/-1.71 months and the mean frequency of recurrence was 1.41+/-0.69 times. Epithelial keratitis developed in 46.2% of the patients, and epithelial keratitis combined with stromal inflammation developed in 36.5%. Previous graft failure due to recurrent HSK and preoperative inflammation were significant risk factors for recurrent HSK after PKP (p=0.019, p=0.006). There were no statistically significant differences in graft rejection and survival rate between the two groups with and without recurrent HSK. CONCLUSIONS: The majority of cases of recurrent HSK after PKP were epithelial keratitis or epithelial keratitis combined with stromal inflammation, and risk factors for the recurrence of HSK were previous graft failure due to recurrent HSK and preoperative inflammation.
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Humans , Eye , Follow-Up Studies , Graft Rejection , Herpes Simplex , Inflammation , Keratitis , Keratitis, Herpetic , Keratoplasty, Penetrating , Methylmethacrylates , Polystyrenes , Recurrence , Rejection, Psychology , Risk Factors , Survival Rate , Sutures , TransplantsABSTRACT
PURPOSE: To investigate the clinical characteristics of herpetic keratitis in Korea. METHODS: A retrospective analysis was performed on 90 eyes of 84 patients who were clinically diagnosed with herpetic keratitis and were followed for at least 4 months or more. Information on prior herpetic keratitis, type of keratitis, time to remission, recurrence rate, administration of oral acyclovir, final visual acuity was reviewed. Remission time and recurrence rate were compared according to types of herpetic keratitis and the application of oral acyclovir in epithelial, stromal or endothelial keratitis; and the relation of history of previous herpetic keratitis, recurrence and final vision, was analyzed. RESULTS: Sex ratio (M:F) was 1.31 and the mean age was 54.6 years. Of 90 eyes, the proportion of infectious epithelial keratitis, stromal keratitis, endothelitis and neurotrophic ulcer was 51.1, 17.8, 25.6 and 5.6%, respectively. The mean remission time was 1.92+/-1.01, 4.13+/-5.05, 5.52+/-5.08, 4.00+/-1.00, respectively (p=0.001, one-way Anova). Recurrence occurred in 21 (42.9%) eyes of 49, which were followed up for more than 12 months, in a year after the previous attack. The rates of recurrence of infectious epithelial keratitis, stromal keratitis and endothelitis were 25.0%, 63.6% and 53.8%, respectively. Oral acyclovir neither shortens the remission nor prevents the recurrence. The percentage of final vision over 20/40 in infectious epithelial keratitis, stromal keratitis and endothelitis was 81.1, 57.1 and 60.0%, respectively. The final vision was worse in the group with a history of herpetic keratitis. CONCLUSIONS: Stromal keratitis and endothelitis showed a higher recurrence rate and longer remission time than infectious epithelial keratitis. Because recurrent and severe keratitis may result in corneal opacity and vision loss, aggressive and proper treatment is needed. However, these cases are often resistant to therapy.
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Humans , Acyclovir , Corneal Opacity , Keratitis , Keratitis, Herpetic , Korea , Recurrence , Retrospective Studies , Sex Ratio , Ulcer , Visual AcuityABSTRACT
PURPOSE: To use impression cytology to examine the structural changes in corneal epithelial cells infected with the herpes simplex virus in rabbit eyes. METHODS: Corneal surfaces of 7 rabbits were scratched using a 25-gauge needle. Herpes simplex virus (type 1, Kos strain) was inoculated to the injured cornea. As the corneal diseases were observed using slit lamp biomicroscopy, impression cytology was performed for 18 days after inoculation. Specimens were stained with hematoxylin-eosin and examined using optical microscopy. RESULTS: Corneal lesions consisted mainly of round epithelial cells, inflammatory cells, ballooning cells, multinucleated giant cells, and various inclusion bodies. Over time, the corneal epithelial cells peeled away as a result of corneal edema in the corneal lesions. Dendritic lesions were also observed. In the recovery phase, the number of detached cells and infiltrated inflammatory cells decreased. CONCLUSIONS: It was presumed that dendritic lesions might have been formed at the scratched cornea region, thereby aggravating the epithelial cells falling off as a result of the infiltration of inflammatory cells. These cytopathologic effects occur in experimental herpes simplex keratitis.
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Animals , Rabbits , Chlorocebus aethiops , Cornea/pathology , Cytological Techniques , Epithelium, Corneal/pathology , Keratitis, Herpetic/pathology , Time Factors , Vero CellsABSTRACT
PURPOSE: To report three cases in which herpes simplex keratitis developed after initiation of latanoprost. METHODS: We experienced three patients with herpes simplex keratitis after latanoprost instillation, two patients with open angle glaucoma and one is congenital glaucoma. We preformed herpes simplex virus culture for two cases. RESULTS: One patient with history of herpes simplex keratitis, resolution when latanoprost was stopped; antiviral therapy could not eradicate herpes simplex keratitis until latanoprost was discontinued. The second patient with latanoprost associated herpes simplex keratitis cleared with discontinuation of latanoprost and start of antiviral therapy. The third patient had resolution, only when latanoprost was stopped. The result of viral cultures for two cases was negative. CONCLUSIONS: Clinicians should be aware of development or recurrence of herpes simplex keratitis when laranoprost is used for intraocular pressure control.
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Humans , Glaucoma , Glaucoma, Open-Angle , Herpes Simplex , Intraocular Pressure , Keratitis, Herpetic , Recurrence , SimplexvirusABSTRACT
We evaluated the efficacy of polymerase chain reaction(PCR)in early diagnosis of herpes simplex keratitis(HSK)in rabbit model and compared the sensitivity and specificity of PCR in two kinds of primers. Only one eye of 8 rabbits was inoculated with HSV Type 1(F strain, ATCC VR-73)to induce HSK, and the other eye was used as control. Rabbit cornea was examined under slit lamp examination and PCR test of tear and corneal scraping specimens were performed at 1, 3, 5, 7, and 10th post-inoculation day. The sensitivity of PCR with POL primer was 100%in tear and corneal scraping specimens. The sensitivity of PCR with POL primer and LAT primer were 80%and 100%respectively. PCR test is very useful diagnotic tool for the early diagnosis of HSK in rabbit model. In addition, PCR test with corneal scraping specimens provided better yield compared with tears.
Subject(s)
Rabbits , Cornea , Early Diagnosis , Herpes Simplex , Keratitis, Herpetic , Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
Herpes simplex virus keratits(HSK) is one of the most common external eye diseases that cause corneal blindness, Therefore early diagnosis and proper treatment of HSK are essential. However it is frequently misdiagnosed because it shows non-specific corneal lesion than other infectious corneal disease. And also diagnosis of HSK mostly rely on clinical examination and patient history. We evaluated suspicious HSK patients by indirect immunofluofluorescent(IF) antibody test and analyzed its efficacy in the early diagnosis of HSK. Among 47 patients(47 eyes), 37 patients were suspicious heretic keratitis and others not. Dendritic keratitis patients existed in 17 out of 37 patients and they were evaluated with virus culture and indirect IF test. The result of indirect IF test was confirmed under the immunofluorescent microscope and for virus culture the specimens were inoculated on Vero cells(monkey kidney cells). The positive results of indirect IF test was 28 out of 37 suspicious HSK patients and 1 out of 10 non-suspicious HSK patients. Dendritic HSK patients showed IF positive in 15 out of 17 patients(82.3%). Sensitivity of indirect IF test in suspicious HSK patients was 75.7%(2837) and 88.2%(15/17) in dendritic HSK patients. Indirect IF test was all positive(14/14) in dendritic HSK patients that showed culture positive. From these results, indirect IF test has a high sensitivity in early diagnosis of HSK and might be ussful as a rapid diagnostic tool in HSK patients.
Subject(s)
Humans , Blindness , Corneal Diseases , Diagnosis , Early Diagnosis , Eye Diseases , Herpes Simplex , Keratitis , Keratitis, Dendritic , Keratitis, Herpetic , Kidney , SimplexvirusABSTRACT
Herpes simplex virus keratits(HSK) is one of the most common external eye diseases that cause corneal blindness, Therefore early diagnosis and proper treatment of HSK are essential. However it is frequently misdiagnosed because it shows non-specific corneal lesion than other infectious corneal disease. And also diagnosis of HSK mostly rely on clinical examination and patient history. We evaluated suspicious HSK patients by indirect immunofluofluorescent(IF) antibody test and analyzed its efficacy in the early diagnosis of HSK. Among 47 patients(47 eyes), 37 patients were suspicious heretic keratitis and others not. Dendritic keratitis patients existed in 17 out of 37 patients and they were evaluated with virus culture and indirect IF test. The result of indirect IF test was confirmed under the immunofluorescent microscope and for virus culture the specimens were inoculated on Vero cells(monkey kidney cells). The positive results of indirect IF test was 28 out of 37 suspicious HSK patients and 1 out of 10 non-suspicious HSK patients. Dendritic HSK patients showed IF positive in 15 out of 17 patients(82.3%). Sensitivity of indirect IF test in suspicious HSK patients was 75.7%(2837) and 88.2%(15/17) in dendritic HSK patients. Indirect IF test was all positive(14/14) in dendritic HSK patients that showed culture positive. From these results, indirect IF test has a high sensitivity in early diagnosis of HSK and might be ussful as a rapid diagnostic tool in HSK patients.