Herpes simplex virus (HSV) PCR - dermal lesion specimen
- LIS Mnemonic: HSVPCR
Collect
Dermal lesion swab in viral transport medium
Volume Required
N/A
Minimum Required
N/A
Transport
Keep specimen at 4C
Processing
Specimen Collection from Dermal Lesions: Cells and fluid from fresh vesicles are superior to specimens prepared from other lesion types (e.g vesicles >> pustules >> ulcers >> crusts) for direct antigen detection, PCR and viral culture. Uncap the vesicle with a sterile needle or scalpel blade and use a sterile rayon or Dacron tipped, plastic shafted swab to vigorously swab the base of the lesion to obtain infected epithelial cells. To facilitate binding of the cellular material to the swab, the swab can be premoistened with sterile saline. Be certain to express the excess liquid from the swab before attempting to collect the specimen. For ulcers, use a swab to remove pus without disrupting the lesion base, and then use a fresh sterile swab to vigorously swab the base of the lesion to obtain cells. Crusted lesions should have the crust removed and discarded before collection of cells from the lesion base. NOTE: The yield of HSV from a crusted lesion is quite low for rapid antigen and culture-based tests and moderate for PCR, so the utility of collecting specimens from this type of lesion should be strongly considered. The swab should be immediately placed in viral transport medium and sent to the Clinical Virology Laboratory.
Unacceptable conditions
Swab specimens not received in viral transport medium or received in bacteriological transport medium are discouraged. DO NOT USE CALCIUM ALGINATE OR WOODEN SHAFT SWABS FOR COLLECTION OF SPECIMENS; ONLY USE DACRON OR RAYON TIPPED SWABS ON PLASTIC OR METAL SHAFTS.
Days Performed
Daily
Reported
Same day
Reflex Testing
N/A
CPT
87529
Methodology
Amplification and detection of HSV DNA polymerase gene using TaqMan real-time PCR technology. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
Interpretation
If positive, results are reported as herpes simplex virus DNA detected.
Reference Values
Negative or no herpes simplex virus DNA detected
Remarks
Clinical Utility: PCR of CSF specimens is now considered the 'gold standard' for the detection of HSV in patients with HSV encephalitis or other HSV-related central nervous system diseases such as recurrent meningitis. PCR can also be used to accurately diagnose HSV infections of the skin and mucous membranes and for the diagnosis of HSV neonatal disease. For diagnosis of neonatal HSV infection, collect specimens from skin vesicles, conjunctiva, mouth or nasopharynx, urine, blood, stool or rectum, and CSF. Detection of HSV from any of these sites more than 48 hours after birth may indicate active viral replication and infection of the infant rather than colonization after intrapartum exposure.
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