Diagnosis of Infections Caused by Herpes Viruses and Chlamydia
Charles Grose, MD
Peer Review Status: Internally Peer Reviewed
Laboratory Hours and Location
Location: The University of Iowa Hospitals' Viral Diagnostic Laboratory is located in 265 Medical Research Center
Telephone Number: 356-4463
Hours: The University of Iowa Hospitals Viral Diagnostic Laboratory is open from 8:00 am to 4:30 pm Monday through Friday and from 8:00 to 11:00 am Saturday and Sundays. Specimens should be in the laboratory no later than 4:00 pm Monday through Friday for processing.
Receipt of Specimens After Hours: Every effort should be made to get specimens to the laboratory on the same day they are collected (by 4:00 pm). Overnight storage of specimens, especially urines and tissues, should be avoided; it is preferable to obtain the specimen early the next morning. When this is not feasible, specimens should be taken after 4:00 pm M-F and 0800 to 0800 S-S to 6248 RCP, Specimen Control. All specimens must be on ice.
Collection of the specimen into appropriate transport media is essential to ensure viability of the organisms to be cultured.
Swabs: Virocult; Chlamydia Transwab
Available from Hospital Stores during regular working hours. Specimen Control during off-hours.
Tissue: Broth medium available in the Virology Lab, Specimen Control, 6248 RCP, Frozen Section Room.
Specimen Collection Guidelines For Clinical Virology Lab
Send all specimens to 265 MRC or Specimen Control 6248 RCP ON ICE.
Isolation and Identification of Herpes simplex, cytomegalovirus, varicella-zoster, respiratory syncytial virus, Chlamydia trachomatis; rotavirus antigen detection; varicella-zoster immune status; and rubella immune status.
Do not clean area to be cultured with alcohol.
- Herpesviruses (CMV, HSV, VZV)
- Vesicle Fluid: Virocult swab of fluid obtained from disrupted vesicle or lesion.
- Spinal Fluid: Aseptic collection into sterile containers.
- Biopsy and autopsy tissue: Immerse tissue in broth transport media.
- Ulcerative lesions: Swabs (anal, genital, ocular). Use Virocult swab and scrape surface of lesion.
- Urine: Freshly passed AM urine is preferable. Collect clean voided midstream sample or suprapubic aspirate in sterile container. At least two or three specimens should be obtained to maximize recovery of CMV.
- Rubella and Varicella serology: Submit at least 2 ml of clotted whole blood (red top tube) not necessary to hand carry or put on ice.
- Buffy coat culture: Submit at least 1 ml of heparinized blood (green top tube).
- Respiratory Syncytial Virus: NP Washings, Tracheal aspirates, sputum; Throat swab as last resort.
- Human Immunodeficiency Virus (HIV)
HIV serology. Submit at least 2 ml of clotted whole blood (red top tube).
Call State Hygienic Laboratory in Iowa City to obtain current instructions about methods for culturing HIV from blood or other specimens. Remember to obtain consent forms prior to submitting specimens.
For best results specimens should be aseptically collected with some vigor (swabbing or scraping) to insure an adequate number of epithelial cells in collection media.
- Swab: sterile Chlamydia Transwab * Conjunctiva: firmly stroke the everted lower eyelid with swab; place swab into transport media and transport to the lab on ice.
- Nasopharyngeal Wash: (Transwab acceptable)
- Draw approximately 1-3 ml phosphate buffered saline (PBS) into an infant bulb syringe (or normal saline without preservatives).
- Inject fluid into nostrils carefully.
- Aspirate fluid from nostril into bulb syringe. Place contents into sterile tube.
- Urine: Not suitable for Chlamydia culture.
Rotavirus Antigen Detection
Liquid fecal specimen in sterile container. Swabs not acceptable.
Transport of Specimens
Carry all specimens ON ICE to:
Virology Lab 265 MRC M-F 8 a.m. - 4:30 p.m.
Specimen Control 6248 RCP all other times.
Storage of Specimens After Hours:
Viral lability away from living cells necessitates that all viral specimens be transported on ice as rapidly as possible to the laboratory. When a specimen must be obtained after the laboratory is closed, specimens should be refrigerated at 4°C, if storage is less than or equal to 48 hrs. Otherwise specimens should be stored frozen at -70° C. Exceptions are urine specimens and tissue specimens which should not be frozen and ideally should be obtained the day they are to be cultured.
|Clinical Disease Commonly||Associated with Virus||Clinical Specimens||Transport System|
|HSV - I, IITable cellTable cell||Mouth + Lips:
||vesicle fluid or swab; throat swab||Virocult|
||vesicle fluid or swab;||Virocult|
|Brain bx*; CSF; HSV PCR
|Tissue Transport Media; Virocult|
|aseptic meningitis||Buffy coat||Green top tube|
|vesicle fluid* or swab|
|urine*; Buffy coat*; biopsy; vesicle swab*; throat swab*; bronchial washings; rectal swab*; conjunctivae||Heparinized (green top) tube
|Zoster||lesion swab or fluid (CSF)||Virocult|
newborn (pregnant mother with chickenpox)
|serum||Red top tube|
|throat swab, vesicle swab* or fluid, CSF*, urine, bronchial washings||Virocult|
|urine*, buffy coat;||Green top tube,|
hepatitis, pneumonia, mononucleosis
|urine*, buffy coat;||Green top tube,|
|biopsy||Tissue Transport Media|
neonate and adult conjunctivitis
|swab*||Chlamydia transport media|
|nasal wash*;||Chlamydia transport media|
|? adult pneumonia||nasopharyngeal swab|
* Recommended specimen for optimal growth in culture