Recurrent herpes simplex labialis: viral replication and clinical course.

The purpose of this study was to provide additional information on the clinical course and viral replication kinetics of herpes simplex virus (HSV) in recurrent herpes labialis. Data were obtained on 20 subjects who were followed for five days from the first day of the lesion. HSV was isolated in 17 subjects (85%); 75% were positive on day 1 of the lesion. Median HSV titer on day 1 was 1.7 x 10(3)/0.2ml. Isolation rates and titers dropped sharply and virus could no longer be detected by day 4. The clinical course both in terms of the frequency and the severity of the symptoms paralleled the kinetics of viral replication. Thermography delineated location of subsequent lesions in three early symptomatic patients who were studied at the time when no visible lesions were observed. These data are felt to provide useful background information for future studies on the efficacy of topical antiviral agents.

Correlation of antistaphylococcal antibody titers with severity of staphylococcal disease.

Counterimmunoelectrophoresis (CIE) was utilized to determine antistaphylococcal precipitin antibody titers in patients with various staphylococcal diseases and in control subjects. Patients with staphylococcal disease comprised five cases of endocarditis, 22 of deep tissue infection (including seven cases of osteomyelitis), six of bacteremia and six of skin infection. Control subjects consisted of 31 patients with nonstaphylococcal bacteremias, 29 hospitalized patients without infection and 30 healthy subjects. Antistaphylococcal antibodies were present in all patients with staphylococcal endocarditis and deep tissue staphylococcal infection, and all but three had titers greater than or equal to 1:4. No significant difference in titers was found between these two groups of patients. Antibodies, although present in some patients in the other categories, were detected less frequently; only two patients had titers greater than or equal to 1:4. Thus, an antistaphylococcal antibody titer by CIE of 1:4 or greater may be an additional diagnostic parameter helpful in distinguishing patients with staphylococcal endocarditis or deep tissue infection from those with other forms of staphylococcal infection and from noninfected subjects.

Application of counterimmunoelectrophoresis in rapid detection of cytomegalovirus antibodies.

Determination of cytomegalovirus antibodies by counterimmune-electrophoresis correlated well with results of complement-fixation antibody studies. The sensitivity and specificity of the counterimmunoelectrophoresis method (vs. complement fixation) was 88.9%. Fourfold antibody increases detected by complement fixation were also detected by counterimmunoelectrophoresis. In addition, no cross-reaction was observed in the counterimmunoelectrophoresis assay between other DNA viral antisera and cytomegalovirus antigen (Ad-169).

Counterimmunoelectrophoresis in the detection of antibodies against Coccidioides immitis.

In recent years counterimmunoelectrophoresis has been increasingly used in the diagnosis of microbial diseases, and our study was undertaken to evaluate its possible use in the rapid detection of antibodies against Coccidioides immitis. One hundred twelve specimens from 50 patients were studied. The study population comprised the following: Group I, 34 patients with an active coccidioidomycosis infection; Group II, five patients with a positive coccidioidin skin test; Group III, five patients with a negative coccidioidin skin test; and Group IV, six patients with other fungal infections. Counterimmunoelectrophoresis was positive in 93 of 96 specimens in Group I and negative in the other groups. The results obtained by counterimmunoelectrophoresis correlated well with complement fixation and double immunodiffusion and indicate that it is an excellent tool for the diagnosis of patients with coccidioidomycosis.

Comparison of counterimmunoelectrophoresis (CIE) with other serologic tests in the detection of antibodies to Trypanosoma cruzi.

Application of counterimmunoelectrophoresis (CIE) in detection of antibodies against Trypanosoma cruzi in sera of 180 subjects from an endemic area (Bolivia), and 50 subjects from a nonendemic area (U.S.A.) was carried out, and the results were compared to ones obtained with latex agglutination (LA) and indirect hemagglutination (IHA). The optimal conditions for CIE were determined to be as follows: barbitone buffer of pH 8.2 and ionic strength 0.05 M was used in the chambers and in preparing the 1% agarose plates. The wells in the plates were 5 mm in diameter and 3 mm apart. Electric current was applied at 500 volts and 25 mA for 60 minutes. T. cruzi antigen (Center for Disease Control) was used in a dilution of 1:2. The sera were studied undiluted. The study population comprised the following groups: LA+ IHA+ (group I); LA+ IHA- (group II); LA- IHA+ (group III); LA- IHA- (group IV); and the control group (group V). Each group was comprised of 50 sera, except for group II which was comprised of only 30 sera. Antibodies were detected by CIE in 94% of sera in group I, 40% in group II, 76% in group III and 6% in group IV. There were no positive reactions in group V. CIE was positive in 74% of sera from the combined LA+ serum groups (I and II), and in 85% of sera from the IHA+ groups (I and III). A good correlation between CIE and the other tests in the LA+ and IHA+ group (I), and the lack of false positive reactions in group V suggest that CIE is a good diagnostic method for detection of T. cruzi antibodies. However, this study showed that IHA is a more sensitive test in epidemiological surveys than CIE. The finding of 6% sera positive by CIE in group IV may indicate a lower specificity of the test.