OPTIMIZATION OF LABORATORY DIAGNOSTICS FOR CHILDREN WITH PRIMARY HERPETIC STOMATITIS

Abstract

There is the base to use the cytological diagnostic method for children with primary herpetic stomatitis in this article. The advantages of the method are simplicity, accessibility, cheapness. It allows widely used that method in both diagnostic and treatment dynamics. With the same technique of cytological investigation the evaluation of its results is carried out by different authors in different ways. The main false of existing cytological method, some authors consider the study from biopsy only from the erosive mucous of none-keratinized epithelium but without assessment of gums epithelium related to the keratinized type.
The aim of the study is to optimize the cytological diagnostic method in children with acute herpetic stomatitis.
Material and methods. The clinical laboratory examination of 60 children in age period of 1 to 3 years, with primary herpetic stomatitis was carried out. The algorithm to analyze and describe of cytograms from microbioptates of erosive non-keratinized oral mucosa and gingival mucosa was developed. The following stage of the description of each cytogram is observed. In the first stage the number of undamaged and damaged epithelium cells are calculated. At the second stage the cell mass and the type of cells of the connective tissue population (the number of unchanged and destroyed neutrophils, the number of phagocytes, lymphocytes, monocytes and erythrocytes) were determined. The third stage involves the study of the quantitative and qualitative composition of microflora in the material. At the fourth stage, the reaction of adsorption of microorganisms by epithelial cells is determined. All findings are obtained as a result of the analysis of cytograms according to the described method were entered into a special accounting form compiled by the authors in the form of a table, which was compiled for each cytogram.
Results and discussion. The analysis of cytograms made it possible to differentiate the use of drugs at different stages of treatment of acute herpetic stomatitis in children. For example, the prevalence of damaged epithelial cells in smears revealed on the first day of medical care is regarded by the authors as a significant cytopathic effect of the virus and entails antiviral therapy. A decrease in the cytopathic effect of the virus is accompanied by a predominance of intact epithelial cells, which makes it possible to cancel antivirals. The same applies to the appointment of local therapy, taking into account the nature and amount of microflora. The administration and cancellation of other drugs should be meaning the cytological data obtained in the dynamics of monitoring the pathological process. Correction of local therapeutic measures must be carried out taking into account the cytology obtained in the dynamics.
Conclusions. The proposed algorithm for the analysis of cytograms of microbiopsy material in primary herpetic stomatitis in young children allows to optimize the process of diagnosing the pathological process. It becomes possible to correct the prescription of antivirals, taking into account cytology obtained from lesions in the dynamics of observation and treatment of primary herpetic stomatitis.