Herpes Simplex Virus (HSV) Culture and Typing

CPT: 87255
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Test Details

Synonyms

  • ELVIS® HSV
  • Five- to Seven-day Herpesvirus Culture/Type
  • 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 Testing for Virology.

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.

Specimen Requirements

Specimen

Vesicular fluid, ulcerated lesions, pharyngeal and throat swabs, urine, cerebrospinal fluid (CSF), 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 three days after appearance of lesion but no more than seven 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

Refrigerate.

Stability Requirements

Temperature

Period

Refrigerated

7 days

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 stored or transported greater than seven days refrigerated; specimen stored or transported at room temperature; wooden shaft swab in transport device; unlabeled specimen or name discrepancy between specimen and test request label

Clinical Information

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.

References

Arvin AM, Prober CG. Herpes simplex viruses. In: Balows A, Hausler WJ, et al, eds.Manual of Clinical Microbiology. 5th ed. Washington, DC: ASM Press; 1991:822-828.
Drew WL. Diagnosis and treatment of viral infections. Clin Lab Med. 1987; 7(4):721-729;4. 3691015
Reichman RC. Herpes simplex viruses. In: Balows A, Hausler WJ, et al, eds.Textbook of Human Virology. Littleton, Mass: PSG Publishing Co; 1984:811-828.
Solomon AR. New diagnostic tests for herpes simplex and varicella zoster infections. J Am Acad Dermatol. 1988; 18(1 Pt 2):218-221.2448353

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
008250 HSV Culture and Typing 5859-4 057943 HSV Culture/Type 5859-4

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