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Aid in the diagnosis of viral diseases (eg, conjunctivitis, congenital viral infections, keratitis, chickenpox, shingles, viral pneumonia, and diseases characterized by skin vesicles and rashes).
For all practical purposes, many common viruses are not culturable: Coxsackie A viruses, hepatitis viruses, arboviruses, parvoviruses, human papillomaviruses, reoviruses, measles virus, and gastrointestinal viruses (rota, corona, calici, astro, and Norwalk). Isolation of virus may not be related to the patient's disease. Some positive cultures are sent to State Health Laboratory for specific virus identification. Infectious HSV is rarely present in CSF during encephalitis, resulting in a poor recovery by culture (<5% in adults, <50% in children). Studies have shown a >98% detection of HSV DNA in CSF by polymerase chain reaction (PCR), and this method is now considered the standard for diagnosis of HSV encephalitis. For HSV PCR testing, please order test 138651.
Give date of onset of illness, date of collection, and brief clinical description or the provisional diagnosis. For example, does the patient have a rash, a respiratory illness, or neurological symptoms?
Viral cultures: Specimens should be collected in the acute stage of the illness, kept moist, and refrigerated immediately. Stool specimens should not be placed into viral transport medium or frozen. Spinal fluid and throat washings must be kept cold and must not be frozen. Swabs of lesions or of throat should be rinsed immediately into 1 or 2 mL of viral transport medium; preferably, the swab should be broken off into the medium and sent in the medium to the laboratory. Autopsy material should be collected in sterile containers. Urine specimens for CMV culture must not be frozen; they should be packed with an ice pack or snow gel, but not with dry ice.
Belshe RB, ed. Textbook of Human Virology. Littleton, Mass: PSG Publishing Co;1984.
Drew WL. Controversies in viral diagnosis. Rev Infect Dis. 1986 Sep-Oct; 8(5):814-824. PubMed 3024292
Korones SB. Uncommon virus infections of the mother, fetus, and newborn: Influenza, mumps, and measles. Clin Perinatol. 1988 Jun; 15(2):259-272. PubMed 3288423
Lennette DA. Preparation of specimens for virological examination. In: Balows A, Hausler WJ, et al, eds. Manual of Clinical Microbiology. 5th ed. Washington, DC: ASM Press;1991:818-821.
Pfaller MA, Caliendo AM, Versalovic J. Detection of herpes simplex virus in CSF by PCR. In: Isenberg HD, ed. Clinical Microbiology Procedures Handbook. 2nd ed. Washington, DC: ASM Press: 2004:12.2.3.51-12.2.3.61.
