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:

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

VZV DNA testing

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

Microscopic Findings

References

  1. 1.0 1.1 Gershon AA, Breuer J, Cohen JI, Cohrs RJ, Gershon MD, Gilden D; et al. (2015). "Varicella zoster virus infection". Nat Rev Dis Primers. 1: 15016. doi:10.1038/nrdp.2015.16. PMC 5381807. PMID 27188665.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 "Public Health Image Library (PHIL)".


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