Recommended test for the diagnosis of acute Herpes (HSV 1 and/or HSV 2) infection.
For encephalitis patients: Consider repeat testing 3 - 7 days post negative HSV PCR result if demonstrating clinical syndrome/temporal lobe localization on neuroimaging.
For viruses, bacteria, and fungi associated with community-acquired meningitis and encephalitis, order Meninigitis/Encephalitis Panel by PCR (LAB4894)
Collect
CSF Cutaneous/Mucocutaneous: Swabbed lesions of the Anal, Genital, Throat, Mouth, Eye or Skin regions, or a Neonatal surface swab
Specimen Container
CSF: Sterile, leak-proof transport tube Lesions: Preferred: Regular tip flocked swab in Universal Transport Media (UTM), Remel M4RT, or similar viral transport media
Preferred Collection Device
UTM with flocked swab
Specimen Preparation
CSF: Transfer 1mL (min 0.5mL) CSF to a sterile leak-proof screw-capped tube
Cutaneous/Mucocutaneous Lesions:
Preferred: Unroof the fresh lesion and swab the base of the lesion with a regular tip flocked swab. Place flocked swab in UTM or acceptable viral transport media, break off swab shaft to prevent lid interference and leakage while capping.
Pediatric Collection
Neonatal surface swabs: Using a flocked swab, sample the conjunctiva, mouth, nasopharynx, and rectum. When neonatal HSV is suspected, additional concurrent alternative testing of serum and CSF should be performed.
Storage/Transport Temperature
Refrigerated
Unacceptable Conditions
CSF: unrefrigerated Cutaneous/Mucocutaneous: Any transport media other than UTM, UVT, Remel M4RT, M4, M5 or M6. No swab in collection tube. Calcium alginate swabs.
Remarks
Specimen source required.
Stability (from collection to initiation)
CSF: Ambient: Unacceptable; Refrigerated: 7 days; Frozen: -70°C for prolonged storage or testing past 7 days Universal Transport Media (UTM): Ambient: 2 hours; Refrigerated: 7 days; Frozen: -70°C for prolonged storage or testing past 7 days
Notes
The performance of this test has not been established for screening of blood/blood products or for use with samples other than CSF and cutaneous lesions.
Serological testing is not recommended.
Negative HSV-1 and HSV-2 results can occur as lesions age and indicate a lack or viral shedding. A negative result does not confirm the absence of a current or previous infection and should not be the sole basis for treatment or patient management decisions.
Ordering Recommendations
Recommended test for the diagnosis of acute Herpes (HSV 1 and/or HSV 2) infection.
For encephalitis patients: Consider repeat testing 3 - 7 days post negative HSV PCR result if demonstrating clinical syndrome/temporal lobe localization on neuroimaging.
For viruses, bacteria, and fungi associated with community-acquired meningitis and encephalitis, order Meninigitis/Encephalitis Panel by PCR (LAB4894)
EPIC Order Code
LAB5319
Sunquest Code
HSVNAT
Synonyms
LAB5319
HSV type 1
HSV type 2
HSV-1 or HSV-2
HSV1 and HSV2
Herpes
CPT Codes
87529 x2
LOINC
16130-7
16131-5
Reference Interval
HSV-1: Not Detected
HSV-2: Not Detected
Interpretive Data
A negative result does not confirm the absence of a current or previous infection and should not be the sole basis for treatment or patient mangement.
This test is only FDA approved for CSF and cutaneous/mucocutaneous lesion sources.
Collection
Ordering Recommendations
Recommended test for the diagnosis of acute Herpes (HSV 1 and/or HSV 2) infection.
For encephalitis patients: Consider repeat testing 3 - 7 days post negative HSV PCR result if demonstrating clinical syndrome/temporal lobe localization on neuroimaging.
For viruses, bacteria, and fungi associated with community-acquired meningitis and encephalitis, order Meninigitis/Encephalitis Panel by PCR (LAB4894)
Collect
CSF Cutaneous/Mucocutaneous: Swabbed lesions of the Anal, Genital, Throat, Mouth, Eye or Skin regions, or a Neonatal surface swab
Specimen Container
CSF: Sterile, leak-proof transport tube Lesions: Preferred: Regular tip flocked swab in Universal Transport Media (UTM), Remel M4RT, or similar viral transport media
Preferred Collection Device
UTM with flocked swab
Specimen Preparation
CSF: Transfer 1mL (min 0.5mL) CSF to a sterile leak-proof screw-capped tube
Cutaneous/Mucocutaneous Lesions:
Preferred: Unroof the fresh lesion and swab the base of the lesion with a regular tip flocked swab. Place flocked swab in UTM or acceptable viral transport media, break off swab shaft to prevent lid interference and leakage while capping.
Pediatric Collection
Neonatal surface swabs: Using a flocked swab, sample the conjunctiva, mouth, nasopharynx, and rectum. When neonatal HSV is suspected, additional concurrent alternative testing of serum and CSF should be performed.
Storage/Transport Temperature
Refrigerated
Unacceptable Conditions
CSF: unrefrigerated Cutaneous/Mucocutaneous: Any transport media other than UTM, UVT, Remel M4RT, M4, M5 or M6. No swab in collection tube. Calcium alginate swabs.
Remarks
Specimen source required.
Stability (from collection to initiation)
CSF: Ambient: Unacceptable; Refrigerated: 7 days; Frozen: -70°C for prolonged storage or testing past 7 days Universal Transport Media (UTM): Ambient: 2 hours; Refrigerated: 7 days; Frozen: -70°C for prolonged storage or testing past 7 days
Notes
The performance of this test has not been established for screening of blood/blood products or for use with samples other than CSF and cutaneous lesions.
Serological testing is not recommended.
Negative HSV-1 and HSV-2 results can occur as lesions age and indicate a lack or viral shedding. A negative result does not confirm the absence of a current or previous infection and should not be the sole basis for treatment or patient management decisions.
Ordering
Ordering Recommendations
Recommended test for the diagnosis of acute Herpes (HSV 1 and/or HSV 2) infection.
For encephalitis patients: Consider repeat testing 3 - 7 days post negative HSV PCR result if demonstrating clinical syndrome/temporal lobe localization on neuroimaging.
For viruses, bacteria, and fungi associated with community-acquired meningitis and encephalitis, order Meninigitis/Encephalitis Panel by PCR (LAB4894)
EPIC Order Code
LAB5319
Sunquest Code
HSVNAT
Synonyms
LAB5319
HSV type 1
HSV type 2
HSV-1 or HSV-2
HSV1 and HSV2
Herpes
Fees & Codes
CPT Codes
87529 x2
LOINC
16130-7
16131-5
Clinical & Interpretive
Reference Interval
HSV-1: Not Detected
HSV-2: Not Detected
Interpretive Data
A negative result does not confirm the absence of a current or previous infection and should not be the sole basis for treatment or patient mangement.
This test is only FDA approved for CSF and cutaneous/mucocutaneous lesion sources.
