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7) Tzanck Preparation

Defnition

Tzanck preparation is a rapid test done to diagnose inections caused by

herpesviruses. Cells are examined under a microscope or signs o inection.

Purpose

Herpesviruses are responsible or several superfcial inections. aricella zoster virus

causes chickenpox and shingles! herpes simplex type " causes the common cold

sore or ever blister! and herpes simplex type # causes the sexually transmitted

disease genital herpes. They are all characterized by blisters and ulcers.

Physicians usually can diagnose herpes inections simply by looking at the type o

blisters and ulcers! and their distribution on the person$s body. %ometimes

laboratory evidence o herpes is needed to confrm the diagnosis. &or example!

herpes can be devastating to a ne'born baby or a person 'ith a 'eakened immunesystem. Treatment can begin once herpes is confrmed in a laboring mother$s

genital ulcers or in the skin blisters o an immunocompromised person. ( lab tries to

gro' )culture* the virus that may be present in the blister. This lab test takes

several days to complete! but the Tzanck preparation takes minutes.

Description

The Tzanck preparation is done by smearing cells taken rom a resh blister or ulcer

onto a microscope slide. The cells are stained 'ith a special stain! such as +right$s

stain! and then examined under a microscope or characteristic changes caused by

a herpesvirus. Herpes causes giant cells 'ith multiple nuclei. The shape o eachnucleus appears molded to ft together 'ith those ad,acent. The background o the

cell looks like ground glass and contains small dark spots called inclusion bodies.

Tzanck preparation is also called a Tzanck smear! herpes stain or inclusion bodies!

or inclusion bodies stain. -esults are available the same or ollo'ing day! oten

'ithin minutes.

Preparation

( resh blister is opened 'ith a scalpel or sterile needle. The physician scrapes the

base o the blister 'ith the scalpel! gathers as much cellular material as possible!

and gently spreads it on a microscope slide.

ormal results

( normal smear sho's no evidence o a herpes inection. This test may also have

alse negatives. %tudies have sho'n that the Tzanck preparation sho's signs o

inection in only /01234 o people 'ith a herpes inection. ( negative Tzanck

preparation may have to be confrmed by a herpes culture.

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(bnormal results

( smear that sho's evidence o herpes inection does not distinguish bet'een the

various inections caused by herpes virus. The physician uses the person$s

symptoms and other clinical fndings to distinguish bet'een these inections. 5n

certain cases! the physician 'ill ollo' a positive Tzanck smear 'ith a culture or

confrmation.

6ey terms

Herpes 7 ( amily o viruses including herpes simplex types " and #! and herpes

zoster )also called varicella zoster*. Herpes viruses cause several inections! all

characterized by blisters and ulcers! including chickenpox! shingles! genital herpes!

and cold sores or ever blisters.

-esources

Henry! 8ohn 9.! editor. Clinical Diagnosis and :anagement by ;aboratory :ethods.

"3th ed. Philadelphia< +. 9. %aunders Co.! "33=.