Herpes Simplex Virus (HSV) Culture and Typing

Herpes Simplex Virus (HSV) Culture and Typing

Number
	008250
CPT
	87255
Related Information
	Default Test Order for Ambiguous Orders Herpes Simplex Virus (HSV) Culture Without Typing Viral Culture, Rapid, Lesion (Herpes Simplex Virus and Varicella-Zoster Virus)
Synonyms
	ELVIS® HSV ; Five- to Seven-Day Herpesvirus Culture/Type ; Herpes Simplex ; HSV Culture and Typing ; Viral Culture, HSV ; Virus Isolation, Herpes Simplex
Test Includes
	Cell culture by ELVIS® method; identification and typing of herpes simplex virus. CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. Requests with only a written order and no test number indicated will be processed according to Default Test Order for Ambiguous Orders .
Special Instructions
	Submit one specimen per test requested. Specify the exact specimen source/origin (eg, genital lesion). Indicate a specific test number on the request form. Check expiration date of transport; do not use expired devices.
Specimen
	Vesicular fluid, ulcerated lesions, pharyngeal and throat swabs, urine, cerebrospinal fluid, autopsy and biopsy material, eye exudates, vaginal swabs
Volume
	Swab in viral transport media, 1 mL fluid, 0.5 g tissue in transport medium
Container
	Viral, Chlamydia, or Mycoplasma culture transport provided by LabCorp, or other appropriate transport medium; body fluids and tissue samples may be submitted in viral transport media or in a sterile leakproof container.
Collection
	Specimen is best collected within the first 3 days after appearance of lesion but no more than 7 days. After collection, remove cap from the transport media tube and insert swab aseptically into transport tube and break swab shaft. Replace cap so that swab will not interfere with closure and allow tube to leak. Label tube with patient identification and transport to the laboratory at 4°C.
Storage Instructions
	Specimen should be kept at 4°C (refrigeration) and transported to the laboratory within 24 hours of collection.
Causes for Rejection
	Bacterial swab specimen; specimen received in grossly leaking transport container; dry specimen; specimen submitted in fixative or additive; specimen received in expired transport media or incorrect transport device; inappropriate specimen transport conditions; specimen received after prolonged delay in transport (usually more than 72 hours); specimen stored or transported at room temperature; wooden shaft swab in transport device; calcium alginate swab; unlabeled specimen or name discrepancy between specimen and request label
Methodology
	Enzyme-linked virus-inducible system (ELVIS®). ELVIS® HSV was developed using a transgenic baby hamster kidney-21 cell line. In this cell line, HSV infection causes the expression of a beta-galactosidase “reporter gene”, and it is the expression of this gene that can be used to monitor infection by HSV. Cultures positive by ELVIS® are confirmed by immunofluorescent staining.
Additional Information
	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 request test 138651. HSV is occasionally isolated from the CSF of patients with HSV 2 meningitis and of neonates with congenital herpes, and from urine of patients with primary genital HSV infections concurrent with cystitis.
References
	Arvin AM and Prober CG, “Herpes Simplex Viruses,” Manual of Clinical Microbiology, 5th ed, Balows A, Hausler WJ, et al, eds, Washington, DC: ASM Press, 1991, 822-8. Drew WL, “Diagnosis and Treatment of Viral Infections,” Clin Lab Med, 1987, 7(4):721-924. Reichman RC, “Herpes Simplex Viruses,” Textbook of Human Virology, Belshe RB, ed, Littleton, MA: PSG Publishing Co, 1984, 811-28. Solomon AR, “New Diagnostic Tests for Herpes Simplex and Varicella Zoster Infections,” J Am Acad Dermatol, 1988, 18(1 Pt 2):218-21.