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Test Code VIRNR Viral Culture, Non-Respiratory, Varies

Reporting Name

Viral Culture, Non Respiratory

Useful For

Diagnosing viral infections in nonrespiratory specimens

 

This test is not useful for viruses that cannot be detected in cell culture including Epstein-Barr virus, rubella virus (order serology), West Nile virus, human papillomavirus, Norwalk virus, or norovirus.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Ordering Guidance


Source-based recommendations for testing:

Dermal specimens: Leg, arm, skin, axilla, etc:

Order LHSV / Herpes Simplex Virus (HSV), Molecular Detection, PCR, Varies and/or LVZV / Varicella-Zoster Virus, Molecular Detection, PCR, Varies. If a dermal sample is submitted for viral culture, the laboratory will automatically change the testing to LHSV and LVZV.

 

Genital specimens: Cervical, endocervical, genital, labia, penis, perianal, scrotum, vaginal

Order LHSV / Herpes Simplex Virus (HSV), Molecular Detection, PCR, Varies. If a genital sample is submitted for viral culture, the laboratory will automatically change the testing to LHSV.

 

Oral specimens: Gum, mouth, palate, tongue, tonsil, parotid, buccal

Order separate polymerase chain reaction (PCR) tests as appropriate:

LCMV / Cytomegalovirus (CMV), Molecular Detection, PCR, Varies

LHSV / Herpes Simplex Virus (HSV), Molecular Detection, PCR, Varies

LENT / Enterovirus, Molecular Detection, PCR, Varies

LADV / Adenovirus, Molecular Detection, PCR, Varies

LVZV / Varicella-Zoster Virus, Molecular Detection, PCR

 

Respiratory specimens: Bronchoalveolar lavage, bronchial wash, lung, lung tissue, nasal swab, nasal wash, sputum, throat swab, tracheal aspirate

Order RP / Respiratory Panel, PCR, Nasopharyngeal (NP) for NP swabs and RPB / Respiratory Panel, PCR, Varies for bronchoalveolar lavage, bronchial washings.

For other respiratory sources order separate PCR tests as appropriate:

LCMV / Cytomegalovirus (CMV), Molecular Detection, PCR, Varies

LHSV / Herpes Simplex Virus (HSV), Molecular Detection, PCR, Varies

LENT / Enterovirus, Molecular Detection, PCR, Varies

LADV / Adenovirus, Molecular Detection, PCR, Varies

LVZV / Varicella-Zoster Virus, Molecular Detection, PCR

 

Infectious agent-based recommendations for testing:

If cytomegalovirus (CMV) is suspected in bone marrow or urine specimens, order LCMV / Cytomegalovirus (CMV), Molecular Detection, PCR, Varies

 

If herpes simplex virus (HSV) is suspected in a neonatal patient (<1 month), order VHSV / Herpes Simplex Virus (HSV), Culture From Neonates, Varies

 

State Health Department testing only: specimens will not be accepted for viral culture at Mayo Clinic Laboratories for the following diseases (submit directly to your state health department).

-Measles

-Mumps

-High-risk infectious agents including, but not limited to, Ebola and other causative agents of viral hemorrhagic fever, avian influenza, severe acute respiratory syndrome (SARS), Middle Eastern respiratory syndrome coronavirus (MERS-CoV), and SARS CoV-2 (coronavirus 2019: COVID19)



Shipping Instructions


1. Specimen must be transported at refrigerate temperature.

2. Swab specimens should be sent in viral transport media.

3. Specimens must be received and cultured in the laboratory within 7 days post collection.

4. Specimens for viral culture should be transported to the laboratory as soon as possible for optimal recovery.



Necessary Information


Specimen source is required.



Specimen Required


Specimen Type: Body fluid

Sources: Pericardial, peritoneal, amniotic

Container/Tube: Sterile container

Specimen Volume: 1 mL

 

Specimen Type: Lip

Supplies:

-Swab, Sterile Polyester (T507)

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Container/Tube: Multimicrobe media (M4-RT)

Specimen Volume: Swab

Collection Instructions: Place swab into multimicrobe media (M4-RT, M4, or M5).

 

Specimen Type: Rectal

Supplies:

-Swab, Sterile Polyester (T507)

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Container/Tube: Multimicrobe media (M4-RT)

Specimen Volume: Swab

Collection Instructions: Place swab into multimicrobe media (M4-RT, M4, or M5).

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 1 mL

 

Specimen Type: Feces

Supplies: Stool Collection Kit, Random (T635)

Container/Tube: Sterile container

Specimen Volume: 5-10 g

 

Specimen Type: Tissue

Supplies:

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Sources: Brain, colon, kidney, liver, etc.

Container/Tube: Sterile container containing 1 mL to 2 mL of sterile saline or multi-microbe medium (M4-RT, M4, or M5).

Specimen Volume: Entire collection

 

Specimen Type: Dermal (for enterovirus only)

Supplies:

-Swab, Sterile Polyester (T507)

-M4-RT (T605)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

Container/Tube: Multimicrobe media (M4-RT)

Specimen Volume: Swab

Collection Instructions:

1. Place swab in M4-RT media or other viral transport media (M4 or M5).

2. Clearly label "enterovirus" to ensure proper handling and test setup.


Specimen Minimum Volume

Body Fluid or Spinal Fluid: 1 mL
Feces: 5 g
Tissue Biopsy: 5 mm

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated 7 days

Reference Values

Negative

If positive, virus is identified.

Day(s) Performed

Monday through Sunday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

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

Test ID Test Order Name Order LOINC Value
VIRNR Viral Culture, Non Respiratory 6584-7

 

Result ID Test Result Name Result LOINC Value
VIRNR Viral Culture, Non Respiratory 6584-7

Report Available

14 to 20 days

Reject Due To

Gel swab, swab with wood handle, E-swab
Bile (toxic)
Deep seated tissues
Lymph nodes
Synovial fluid
Bone marrow/bone tissue
Wound swabs
Tissue swabs
Pus, abscess and/or drainage material		 Reject

Testing Algorithm

All routine viral cultures are inoculated into cell culture tubes for viral detection. The most common specimens received for routine testing include body fluid, rectal, spinal fluid, and feces. A rapid (16-hour incubation) shell vial cell culture assay will be inoculated when specimens are designated for herpes simplex virus (HSV), adenovirus (AD), or cytomegalovirus (CMV) detection, or as appropriate for source indicated, and will be charged separately for each virus tested.

 

Information pertaining to specific sources:

Acceptable sources:

-Dermal specimens for enterovirus only (clearly indicate "Enterovirus" on test request)

-Feces: rectal swab (preferred); random fecal specimen (acceptable)

-Brain tissue

-Liver tissue (for CMV and herpes) refrigerated in saline or phosphate buffered saline

-Esophageal tissue, swabs, or brushings

 

Sources not recommended or not acceptable:

-Blood, lymph node tissue, and bone marrow/bone tissue specimens are frequently toxic to cell culture lines. Most molecular methods are appropriate for these specimen types (exception: bone tissue).

-Ocular fluids (vitreous and aqueous): viral culture is not recommended due to usually inadequate volumes. Polymerase chain reaction (PCR) testing is recommended

-Genital, synovial fluid, wound swab, or tissue (includes pus, drainage, or abscess fluid)

 

See Ordering Guidance for recommended testing on these specimen types.

Method Name

Cell Culture

Shell Vial Assay for Herpes Simplex Virus or Cytomegalovirus

Secondary ID

87266

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
TISSR Tissue Processing No, (Bill Only) No
VID2 Additional Testing Virus Ident No, (Bill Only) No
SVIR Viral Smear, Shell Vial No, (Bill Only) No