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Case 4: Varicella Zoster Virus

You answered:

A The Tzanck stain is diagnostic for VZV infection and it rules out other causes of vesicular skin lesions, such as herpes simplex virus infection.

This answer is incorrect. The finding of multinucleated giant cells on Tzanck (Giemsa) staining is neither sensitive nor specific for diagnosing viral vesicular lesions. Direct fluorescent antibody (DFA) testing would be more appropriate and can specifically differentiate VZV from other viruses. The DFA uses fluorescent labeled antibodies that detect antigens specific to VZV, and it yields more rapid and accurate results than culture.

Choose another answer:

B The preferred therapy for dermatomal herpes zoster in HIV-infected patients consists of acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir).
C The preferred therapy for dermatomal herpes zoster in HIV-infected patients consists of oral valganciclovir (Valcyte).
D The incidence of herpes zoster in HIV-infected individuals is the same as age-matched HIV-negative persons.

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