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Diagnosing viral infections
All routine viral cultures are inoculated into cell culture tubes for viral detection. The most common specimens received for routine testing include bronchoalveolar lavage, sputum, and throat. A rapid (16-hour incubation) shell vial cell culture assay will be inoculated when specimens are designated for herpes simplex virus or cytomegalovirus detection or as appropriate for source indicated.
-For oral specimens for suspected hand-foot-and-mouth disease or enterovirus, clearly indicate "enterovirus" on request.
Testing for Mumps or Measles Virus: Do not submit specimens for viral culture testing if there is a suspicion of mumps or measles virus. Suspect mumps or measles cases should be submitted directly to a state health department for laboratory testing.
Do not submit specimens for viral culture testing if there is a suspicion of Ebola virus or any viral hemorrhagic fever, avian influenza, severe acute respiratory syndrome (SARS), Middle Eastern respiratory syndrome Coronovirus (MERS-CoV), or other high-risk infectious agents. Contact your state health department for more information and testing options.
Viruses are responsible for a broad spectrum of clinical symptoms and diseases. The most commonly isolated viruses are adenovirus, cytomegalovirus, enteroviruses, herpes simplex virus, influenza virus, parainfluenza virus (types 1-3), respiratory syncytial virus, and varicella-zoster virus.
Many viral infections can now be treated with antiviral drugs. Early laboratory diagnosis by isolation is very helpful in the medical management of these patients.
If positive, virus is identified.
A positive result indicates that virus was present in the specimen submitted. Clinical correlation is necessary to determine the significance of this finding.
Influenza virus infection is a state-mandated reportable disease.
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 culture include Epstein-Barr virus, rubella virus, and papilloma virus), and nonviable organisms submitted. Parainfluenza virus type 4 may also not be detected by viral culture.
Viral isolation depends on the proper collection and transport of the specimen for maximal detection of viruses in the laboratory.
This test is not useful for viruses that cannot be grown in cell culture (see Interpretation).
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