Nasopharyngeal and oropharyngeal swabs
Keep specimen at 4C
Collection of COMBINED THROAT AND NASOPHARYNGEAL SWABS. For collection of nasopharyngeal swab specimen: 1. Insert swab into one nostril. 2. Press swab tip on the mucosal surface of the mid-inferior portion of the inferior turbinate, and rub the swab tip several times across the mucosal surface to loosen and collect cellular material. 3. Withdraw the swab; place swab into tube of Viral Transport Medium. For collection of oropharyngeal swab specimen: 1. Ask patient to open mouth widely and phonate an 'ah'. 2. Gently depress the tongue with a tongue blade. 3. Guide a swab over the tongue into the posterior oropharynx. 4. Using a gentle back-and-forth sweeping motion, swab the area behind the uvula and between the tonsillar pillars. 5. Withdraw the swab; place swab into the same tube of Viral Transport Medium that contains the nasoparyngeal swab. Immediately transport to the Clinical Virology Laboratory. Nasal aspirates or washings, tracheal aspirates, and bronchoalveolar lavage specimens may be submitted. Tracheal or transtracheal aspirates or bronchoalveolar lavage specimens are superior for the indication of lower respiratory tract infections.
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.
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.
If positive, results are reported as herpes simplex virus DNA detected.
Negative or no herpes simplex virus DNA detected
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.