TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: VIRNR    
Viral Culture, Non-Respiratory, Varies

Useful For Suggests clinical disorders or settings where the test may be helpful

Diagnosing viral infections in nonrespiratory specimens

 

This test is not useful for viruses that cannot be detected in cell culture including: Epstein-Barr virus, rubella virus (order serology), West Nile virus, human papillomavirus, Norwalk virus or norovirus.

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

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 feces. A rapid (16-hour incubation) shell vial cell culture assay will be inoculated when specimens are designated for herpes simplex virus (HSV), adenovirus(AD) or cytomegalovirus (CMV) detection, or as appropriate for source indicated, and will be charged separately for each virus tested.

 

Information pertaining to specific sources:

Acceptable sources:

-Dermal specimens for enterovirus only (clearly indicate "Enterovirus" on test request)

-Feces- rectal swab (preferred); random fecal specimen (acceptable)

-Brain tissue

-Liver tissue (for CMV and herpes) refrigerated in saline or phosphate buffered saline

-Esophageal tissue, swabs, or brushings

 

Sources not recommended or not acceptable:

-Blood, lymph node tissue, and bone marrow/bone tissue specimens are frequently toxic to cell culture lines. Most molecular methods are appropriate for these specimen types (exception: bone tissue).

-Ocular fluids (vitreous and aqueous): viral culture is not recommended due to usually inadequate volumes. PCR testing is recommended

-Genital, synovial fluid, wound swab or tissue (includes pus, drainage, or abscess fluid)

See Advisory Information for recommended testing on these specimen types.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Viruses are responsible for a broad spectrum of clinical symptoms and diseases. The most commonly isolated viruses are adenovirus, cytomegalovirus (CMV), enteroviruses, herpes simplex virus (HSV), and varicella-zoster virus (VZV).

 

Many viral infections (eg, HSV, CMV, VZV) can now be treated with antiviral drugs. Early laboratory diagnosis by isolation is very helpful in the medical management of these patients.

 

Viruses that are detected in cell culture include: adenovirus, CMV, enterovirus, HSV, and VZV.

 

Viruses that are not detected in cell culture include: Epstein-Barr virus, rubella virus (must order serology), West Nile virus, human papillomavirus, Norwalk virus or norovirus.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

If positive, virus is identified.

Interpretation Provides information to assist in interpretation of the test results

A positive result indicates that virus was present in the specimen submitted. Clinical correlation is necessary to determine the significance of this finding.

 

Negative results may be seen in a number of situations including absence of viral disease, inability of the virus to grow in culture (examples of organisms not detected by this culture test include Epstein-Barr virus, rubella virus, papilloma, and Norwalk virus), and nonviable organisms submitted.

 

For patients with diarrhea, see Parasitic Investigation of Stool Specimens Algorithm in Special Instructions for other diagnostic tests that may be useful.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Viral isolation and detection depends on the proper collection and transport of the specimen.

 

Some viruses (eg, cytomegalovirus) take up to 2 weeks to grow in viral cell culture. Molecular tests (ie, real-time PCR) should be used for rapid diagnosis.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Clinical and Laboratory Standards Institute 2005. Viral Culture. Proposed Guideline. CLSI document M41-P. Clinical and Laboratory Standards Institute, Wayne, PA

2. Ginocchio CC, Harris PC: Chapter 17: Reagents, stains, and cell culture: Virology. In Manual of Clinical Microbiology. 10th edition. Edited by J Versalovic, KC Carroll, et al. Washington, DC, ASM Press, 2011, pp 1289-1296

3. Smith TF: Antibody-enhanced detection of viruses in cell cultures. In Manual of Clinical Laboratory Immunology. Fifth edition. Edited by NR Rose, EC de Marcio, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 618-624

Special Instructions Library of PDFs including pertinent information and forms related to the test