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.

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
TISSR Tissue Processing No, Bill Only No
VID2 Additional Testing Virus Ident No, Bill Only No
SVIR Viral Smear, Shell Vial No, Bill Only No

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. Polymerase chain reaction (PCR) testing is recommended

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

 

See Ordering Guidance for recommended testing on these specimen types.

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

Method Name
A short description of the method used to perform the test

Cell Culture

Shell Vial Assay for Herpes Simplex Virus or Cytomegalovirus

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Viral Culture, Non Respiratory

Aliases
Lists additional common names for a test, as an aid in searching

Culture for Virus, Routine

Culture, Coxsackie Virus/Echovirus

Echovirus

Herpes 1 and 2 (Culture)

Viral Isolation

Virus (CSF)

Coxsackie Virus (CSF and Rectal Swab)

Herpes or Herpes Simplex Virus Culture

Virus, Stool Culture

Enterovirus (Hand foot mouth disease)

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. Polymerase chain reaction (PCR) testing is recommended

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

 

See Ordering Guidance for recommended testing on these specimen types.

Specimen Type
Describes the specimen type validated for testing

Varies

Ordering Guidance

Source-based recommendations for testing:

Dermal specimens: Leg, arm, skin, axilla, etc:

Order HERPV / Herpes Simplex Virus 1 and 2, Qualitative PCR, Varies and/or LVZV / Varicella-Zoster Virus, Molecular Detection, PCR, Varies. If a dermal sample is submitted for viral culture, the laboratory will automatically change the testing to HERPV and LVZV.

 

Genital specimens: Cervical, endocervical, genital, labia, penis, perianal, scrotum, vaginal

Order HERPV / Herpes Simplex Virus 1 and 2, Qualitative PCR, Varies. If a genital sample is submitted for viral culture, the laboratory will automatically change the testing to HERPV.

 

Oral specimens: Gum, mouth, palate, tongue, tonsil, parotid, buccal

Order separate polymerase chain reaction (PCR) tests as appropriate:

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

HERPV / Herpes Simplex Virus 1 and 2, Qualitative PCR, Varies

LENT / Enterovirus Molecular Detection, PCR, Varies

LADV / Adenovirus, Molecular Detection, PCR, Varies

LVZV / Varicella-Zoster Virus, Molecular Detection, PCR

 

Respiratory specimens: Bronchoalveolar lavage, bronchial wash, lung, lung tissue, nasal swab, nasal wash, sputum, throat swab, tracheal aspirate

Order RP / Respiratory Panel, PCR, Nasopharyngeal (NP) for NP swabs and RESLR / Respiratory Pathogen Panel, PCR, Varies for bronchoalveolar lavage, bronchial washings.

For other respiratory sources order separate PCR tests as appropriate:

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

HERPV / Herpes Simplex Virus 1 and 2, Qualitative PCR, Varies

LENT / Enterovirus Molecular Detection, PCR, Varies

LADV / Adenovirus, Molecular Detection, PCR, Varies

LVZV / Varicella-Zoster Virus, Molecular Detection, PCR

 

Infectious agent-based recommendations for testing:

If cytomegalovirus (CMV) is suspected in bone marrow or urine specimens, order LCMV / Cytomegalovirus (CMV), Molecular Detection, PCR, Varies

 

If herpes simplex virus (HSV) is suspected in a neonatal patient (<1 month), order VHSV / Herpes Simplex Virus (HSV), Culture From Neonates, Varies

 

State Health Department testing only: specimens will not be accepted for viral culture at Mayo Clinic Laboratories for the following diseases (submit directly to your state health department).

-Measles

-Mumps

-High-risk infectious agents including, but not limited to, Ebola and other causative agents of viral hemorrhagic fever, avian influenza, severe acute respiratory syndrome (SARS), Middle Eastern respiratory syndrome coronavirus (MERS-CoV), and SARS CoV-2 (coronavirus 2019: COVID19)

Shipping Instructions

1. Specimen must be transported at refrigerate temperature.

2. Swab specimens should be sent in viral transport media.

3. Specimens must be received and cultured in the laboratory within 7 days post collection.

4. Specimens for viral culture should be transported to the laboratory as soon as possible for optimal recovery.

Necessary Information

Specimen source is required.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Specimen Type: Body fluid

Sources: Pericardial, peritoneal, amniotic

Container/Tube: Sterile container

Specimen Volume: 1 mL

 

Specimen Type: Lip

Supplies:

-Swab, Sterile Polyester (T507)

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Container/Tube: Multimicrobe media (M4-RT)

Specimen Volume: Swab

Collection Instructions: Place swab into multimicrobe media (M4-RT, M4, or M5).

 

Specimen Type: Rectal

Supplies:

-Swab, Sterile Polyester (T507)

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Container/Tube: Multimicrobe media (M4-RT)

Specimen Volume: Swab

Collection Instructions: Place swab into multimicrobe media (M4-RT, M4, or M5).

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 1 mL

 

Specimen Type: Feces

Supplies: Stool Collection Kit, Random (T635)

Container/Tube: Sterile container

Specimen Volume: 5-10 g

 

Specimen Type: Tissue

Supplies:

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Sources: Brain, colon, kidney, liver, etc.

Container/Tube: Sterile container containing 1 mL to 2 mL of sterile saline or multimicrobe medium (M4-RT, M4, or M5).

Specimen Volume: Entire collection

 

Specimen Type: Dermal (for enterovirus only)

Supplies:

-Swab, Sterile Polyester (T507)

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Container/Tube: Multimicrobe media (M4-RT)

Specimen Volume: Swab

Collection Instructions:

1. Place swab in M4-RT media or other viral transport media (M4 or M5).

2. Clearly label "enterovirus" to ensure proper handling and test setup.

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

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

Body Fluid or Spinal Fluid: 1 mL

Feces: 5 g

Tissue Biopsy: 5 mm

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gel swab, swab with wood handle, E-swab
Blood
Serum, bile (toxic)
Deep seated tissues
Lymph nodes
Synovial fluid
Bone marrow/bone tissue
Wound swabs
Tissue swabs
Pus, abscess and/or drainage material
Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days

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. Polymerase chain reaction (PCR) testing is recommended

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

 

See Ordering Guidance 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 depend 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 polymerase chain reaction) should be used for rapid diagnosis.

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

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

2. Ginocchio CC, Harris PC: Reagents, stains, and cell culture: Virology. In: Versalovic J, Carroll KC, et al, eds. Manual of Clinical Microbiology. 10th ed. ASM Press; 2011:1289-1296

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

Method Description
Describes how the test is performed and provides a method-specific reference

Specimens are inoculated into conventional tube cell cultures (MRC-5 and RMK) and observed for the presence of cytopathic effects (CPE) over a 14-day period. Results of viral cultures are reported when typical CPE are detected and the identity of the isolate has been confirmed by immunofluorescence with specific antisera.(Smith TF: Antibody-enhanced detection of viruses in cell cultures. In: Rose NR, de Macario EC, Folds JD, et al, eds. Manual of Clinical Laboratory Immunology. 5th ed. ASM Press; 1997:618-624; Murray PR, Rosenthal KS, Pfaller MA. Laboratory diagnosis of viral disease. In: Medical Microbiology. 9th ed. Elsevier; 2021:396-402)

 

The shell-vial assay is also performed on specimens submitted for cytomegalovirus or herpes simplex virus. Shell-vial results may be positive in 16 to 24 hours postinoculation.(Paya CV, Wold AD, Smith TF: Detection of cytomegalovirus infections in specimens other than urine by the shell vial assay and conventional tube cell cultures. J Clin Microbiol. 1987;25:755-757; Murray PR, Rosenthal KS, Pfaller MA. Laboratory diagnosis of viral disease. In:  Medical Microbiology. 9th ed. Elsevier; 2021:396-402)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

14 to 20 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

87252-Viral culture, non-respiratory

87176-Tissue processing (if appropriate)

87253-Additional testing virus, identification (if appropriate)

87254-Viral smear, shell vial (if appropriate)

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports