Herpes simplex virus (HSV) infects the skin, lips, oral cavity, eyes, genital tract, and central nervous system (CNS) and can produce skin irritations such as rashes, lesions, and shingles. Both genital herpes and viral CNS disease are caused by HSV. Another virus, Varicella zoster virus (VZV), produces a generalized vesicular rash (chickenpox) in children and later causes unilateral vesicular eruptions (shingles) in adults. Early detection of these viruses is very important to prevent suffering in affected patients and transmission to other individuals.
Until recently, physicians have relied on culture to detect these viruses. The virus is almost never recovered in culture systems from cerebrospinal fluid (CSF) specimens, and serologic tests for the detection of antibodies are not always positive during early stages of disease. The polymerase chain reaction (PCR) assay detects viral DNA in specimens and has significantly improved the ability to diagnose HSV and VZV infections. PCR assay is quick, specific, and sensitive–detecting fewer than 10 copies of target. Mayo’s Virology Laboratory has discontinued using cell cultures for these specimen types, making rapid PCR the gold standard for detection of HSV and VZV in genital and dermal specimens.
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