Test ID: VIRNR
Viral Culture, Non-Respiratory
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Diagnosing viral infections
Method Name A short description of the method used to perform the test
All routine viral cultures are inoculated into cell culture tubes for viral detection. Most common specimens received for routine testing include body fluid, ocular, rectal, spinal fluid, and stool. A rapid (16-hour incubation) shell vial cell culture assay will be inoculated when specimens are designated for herpes simplex virus (HSV) or cytomegalovirus (CMV) detection or as appropriate for source indicated.
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Culture for Virus, Routine
Culture, Coxsackie Virus/Echovirus
Echovirus
Enterovirus
Herpes 1 and 2 (Culture)
Herpes or Herpes Simplex Virus Cult
Viral Isolation
Virus (CSF)
Virus, Culture-Stool
50015-VIRNR
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Blood*, bone marrow*, lymph node tissue, dermal, genital, oral, synovial fluid or urine** specimen is not acceptable for viral culture. For dermal or oral specimens for hand-foot-and-mouth disease or enterovirus, clearly indicate "enterovirus" on request. For dermal specimens on neonates (<1 month), clearly indicate "neonate for culture" on request.
1. For requests for cytomegalovirus on bone marrow or urine specimen, see:
a. LCMV/81240 Cytomegalovirus (CMV), Molecular Detection, PCR
2. For requests for herpes simplex virus/varicella-zoster virus on genital or dermal specimen, see:
a. LHSV/80575 Herpes Simplex Virus (HSV), Molecular Detection, PCR
b. LVZV/81241 Varicella-Zoster Virus, Molecular Detection, PCR
c. VDER/82048 Herpes Simplex Virus (HSV) and Varicella-Zoster Virus (VZV), Molecular Detection, PCR, Dermal
*Blood, lymph node tissue, and bone marrow specimens are unproductive and frequently toxic in culture. Most molecular methods are appropriate for these specimen types. See individual real-time PCR assay test descriptions.
**Urine is acceptable only for mumps culture (see below); specimen must clearly indicate "MUMPS" to ensure proper handling and test setup.
Forms: If not ordering electronically, submit a Microbiology Request Form (Supply T244) with the specimen.
Specimen source is required.
Specimen Type: Body fluid
Container/Tube: Sterile container
Specimen Volume: 1 mL
Specimen Type: Ocular or rectal
Container/Tube: Dacron-tipped swab with plastic handle (Supply T507)
Specimen Volume: Swab
Collection Instructions: Place swab in M5 viral transport media.
Additional Information: Swab with a wood handle has been shown to be toxic to some viruses and is not acceptable for culture.
Specimen Type: Spinal fluid
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Specimen Type: Stool
Container/Tube: Sterile container
Specimen Volume: 5-10 g
Specimen Type: Tissue
Sources: Brain, colon, kidney, liver, etc.
Container/Tube: Sterile container with 1 to 2 mL of sterile saline or multi-microbe medium (M5) (Supply T484)
Specimen Volume: Entire collection
Specimen Type: Urine (for mumps only)
Container/Tube: Sterile container
Specimen Volume: 0.5 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | Swab with wood handle; blood, bone marrow, lymph node, dermal, genital, oral, or urine specimen |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Refrigerated | 7 days |
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, enteroviruses, herpes simplex 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.
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.
This test is not useful for viruses (not listed above) that cannot be grown in cell culture (see Interpretation).
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Smith TF: Antibody-enhanced detection of viruses in cell cultures. In Manual of Clinical Laboratory Immunology. 5th edition. Edited by NR Rose, EC de Macario, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 618-624
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 Manual of Clinical Laboratory Immunology. 5th edition. Edited by NR Rose, EC de Macario, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 618-624)
The shell-vial assay is also performed on specimens submitted for cytomegalovirus or herpes simplex virus. Shell-vial results may be positive 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)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Varies
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
87252-Viral culture, non-respiratory
87176-Tissue processing (if appropriate)
87253-Additional testing virus, identification (if appropriate)
87254-Viral smear, shell vial (if appropriate)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| VIRNR | Viral Culture, Non Respiratory | In Process |
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