Herpes simplex Virus Culture

CERNER / EPIC MNEMONIC: C HERPES
POE DESCRIPTION: CU HERPES SIMPLEX; C HERPES
CPT CODE: 87252
TEST INFORMATION: The test includes culture for HSV ONLY.
DAYS PERFORMED: Monday-Saturday
TURNAROUND TIME: 7 days
CONTAINER TYPE: Sealed sterile container, cold  viral transport medium for swabs (available from Clinical Microbiology Laboratory).
COLLECTION: All specimens should be kept cold and moist. As for most viral cultures, specimens should be collected in the acute stage of the disease, preferably within 3 days and no longer than 7 days after the onset of illness. All specimens should be collected on a sterile swab with the swab placed into cold Flex-Trans® transport medium immediately after collection.

Endocervical: Swab cervix with enough force to obtain epithelial cells.

Vesicular lesions: Wash surface of vesicles with sterile saline. Carefully open several vesicles and soak up vesicular fluid with a swab. If vesicles are absent, vigorously swab BASE of lesion (specimen should be collected during first 3 days of eruption since later collection during the course of the disease rarely yields virus).

Conjunctival: Using a moistened swab, firmly rub conjunctiva using sufficient force to obtain epithelial cells.

Throat, respiratory, oral: Rotate swab in both tonsillar crypts and against posterior oropharynx. AVOID the uvula.

SPECIMEN REQUIREMENTS: Specimen depends on type of infection:

» genital: vesicle fluid, lesion, endocervical

» conjunctivitis: conjunctival

» congenital: throat, vesicle

» respiratory/oral: throat, vesicle

REJECTION CRITERIA: Dry specimen, specimen not in viral transport medium, specimen not refrigerated prior to transport, specimen not received in a sealed sterile container, excessive delay in transport, inappropriate specimen container.
MINIMUM VOLUME: 1 mL fluid or one swab in viral transport medium
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. Keep specimen cold and moist. If transportation is to be delayed more than 30 minutes after collection, specimen must be refrigerated (held at 4°C to 8°C) until it can be transported.
REFERENCE RANGE: No Herpes simplex virus isolated
METHODOLOGY: Inoculation of specimen into cell cultures, incubation of cultures, observation of characteristic cytopathic effect, and identification by fluorescent monoclonal antibodies specific for type 1 or type 2.
ADDITIONAL INFORMATION: HSV can only rarely be isolated from the cerebrospinal fluid of patients with HSV type 1 encephalitis; PCR for HSV-1 is the preferred test. The virus is occasionally isolated from the cerebrospinal fluid of patients with HSV type 2 meningitis, from neonates with congenital herpes, and from urine from patients with primary genital HSV infections concurrent with cystitis.
TEST SYNONYM(S):Herpes simplex 1 and 2 Culture; HSV 1 and 2 Culture; HSV Culture; Viral Culture; Herpes simplex