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Viruses are responsible for a broad spectrum of clinical symptoms and diseases. The most commonly isolated viruses are adenovirus, cytomegalovirus, enteroviruses, herpes simplex virus, and varicella-zoster virus.
Many viral infections (eg, herpes simplex virus, cytomegalovirus, varicella-zoster virus) can now be treated with antiviral drugs. Early laboratory diagnosis by isolation is very helpful in the medical management of these patients.
Diagnosing viral infections
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.
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.
This test is not useful for viruses (not listed above) that cannot be grown in cell culture (see Interpretation).
If positive, virus is identified.
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