Testing Algorithm

All routine viral cultures are inoculated into cell culture tubes for viral detection. The most common specimens received for routine testing include body fluid, rectal, spinal fluid, and stool. A rapid (16-hour incubation) shell vial cell culture assay will be inoculated when specimens are designated for herpes simplex virus (HSV) or cytomegalovirus (CMV) detection, or as appropriate for source indicated.

Blood, lymph node tissue, and bone marrow/bone tissue specimens are not good sources for viral culture and are frequently toxic to cell culture lines. Most molecular methods are appropriate for these specimen types (exception: bone tissue). See individual real-time PCR assay test descriptions.

Genital, synovial fluid, wound swab or tissue (includes pus, drainage, or abscess fluid) specimens are not acceptable for viral culture.

Ocular fluids (vitreous and aqueous) are generally of inadequate volume for viral cell culture and molecular testing is typically recommended for these samples. See individual real-time PCR assay test descriptions.

Oral specimens submitted for culture should be ordered as VRESP / Viral Culture, Respiratory.

Dermal specimens are only acceptable for enterovirus culture:

-For dermal specimens for hand-foot-and-mouth disease or enterovirus, clearly indicate "enterovirus" on request.

For requests to rule-out HSV infection in neonates (<1 month) on dermal specimens, order VHSV / Herpes Simplex Virus (HSV), Culture From Neonates.

Testing for Mumps or Measles Virus: Do not submit specimens for viral culture testing if there is a suspicion of mumps or measles virus. Suspect mumps or measles cases should be submitted directly to a state health department for laboratory testing.

Do not submit specimens for viral culture testing if there is a suspicion of Ebola virus or any viral hemorrhagic fever, avian influenza, severe acute respiratory syndrome (SARS), Middle Eastern Respiratory Syndrome Coronovirus (MERS-CoV), or other high-risk infectious agents. Contact your state health department for more information and testing options.

For requests for Cytomegalovirus (CMV) on bone marrow or urine specimen, see:

-LCMV / Cytomegalovirus (CMV), Molecular Detection, PCR

For requests for herpes simplex virus (HSV) or varicella-zoster virus (VZV) on genital or dermal specimen, see:

-LHSV / Herpes Simplex Virus (HSV), Molecular Detection, PCR

-LVZV / Varicella-Zoster Virus, Molecular Detection, PCR

-LHSVZ / Herpes Simplex Virus (HSV) and Varicella-Zoster Virus (VZV), Molecular Detection, PCR