Type of test

Blood; microscopic

Normal findings

No virus present

No HSV antibodies present

Test explanation and related physiology

HSV can be classified as either type 1 or type 2. Type 1 is primarily responsible for oral lesions (blisters on the lips, or “cold sores”) or even corneal lesions. About half of the patients with HSV 1 develop recurrent infections. HSV 2 is a sexually trans mitted viral infection of the urogenital tract.

Because most infants become infected if they pass through a birth canal containing HSV, determining its presence at delivery is necessary. Congenital infections may result in problems such as microcephaly, chorioretinitis, and mental retardation in the newborn. Disseminated neonatal herpes virus infections carry a high incidence of infant mortality. A vaginal delivery is possible if no virus is present, but birth by cesarean section is necessary if HSV is present.

Culture is still the standard criterion for HSV. Culture can be performed only during an outbreak. Serologic tests are more easily and conveniently available for detection of HSV 1 and HSV 2 antibodies. Serologic tests for herpes simplex are useful to supplement cultures or molecular detection for acute infection. The advantage of serology tests is that results can be available in a day. Serologic tests for IgG antibodies are available to help differentiate type 1 from type 2 infection. IgG antibodies indicate a previous exposure. IgM antibodies indicate an acute infection but do not differentiate well between types 1 and 2.

Fresh tissue is the definitive specimen for detection of HSV by molecular detection, particularly in infections involving oral, genital, central nervous system (CNS), ocular, and other sites

. Procedure and patient care

 Before

* Explain the procedure to the patient.

* Tell women to refrain from douching and tub bathing before the cervical culture is performed.

 • Obtain the urethral specimen from men before voiding.

During

 • Obtain cultures as follows:

 Urethral culture

1. A culture is taken by inserting a sterile swab gently into the anterior urethra  or genital skin lesion of the male patient.

2. Place the male patient in the supine position to prevent falling if vasovagal syncope occurs during introduction of the cotton swab or wire loop into the urethra.

3. The patient is observed for hypotension, bradycardia, pallor, sweating, nausea, and weakness.

 Cervical culture

1. The female patient is placed in the lithotomy position, and a vaginal speculum is inserted.

 2. Cervical mucus is removed with a cotton ball.

 3. A sterile cotton-tipped swab is inserted into the endocervical canal and moved from side to side to obtain the culture. If a genital lesion is present, swabs from that area will be more sensitive in indicating infection.

 4. For pregnant women with herpes genitalis, note that the cervix is cultured weekly for the herpes virus beginning 4 to 6 weeks before the due date. Vaginal delivery is possible if the following criteria are met:

 a. The two most recent culture results are negative.

 b. The woman is not experiencing any symptoms.

 c. No lesions are visible on the vagina and vulva.

 d. Throughout pregnancy, the woman has not had more than one positive culture, during which she was symptom-free.

Blood for serology

 • Obtain a venous blood sample in a red-top tube.

Molecular PCR tissue and other fluids

• Obtain CSF or other fluids by sterile technique as described elsewhere in this book.

 • Obtain tissue by appropriate biopsy techniques. After Inform the patient how to obtain the test results.

 Abnormal findings

 Herpesvirus infection

مواضيع ذات صلة

Direct Detection Methods for Bacillus and Similar Organisms

HIV drug resistance testing (HIV genotype)

hepatitis virus studies

Biomarkers of Nutritional Status

Malnutrition

hemoglobin (Hb, Hgb)

hematocrit (Hct, Packed red blood cell volume, Packed cell volume [PCV])

Helicobacter pylori testing (Anti–Helicobacter pylori antibody, Campylobacter-like organism [CLO] test, H. pylori stool antigen)

Nonculture Methods For The Identification Of Pathogenic Microorganisms

Heinz body preparation

Haptoglobin

Transthyretin (Prealbumin)