Viral Immunodiagnostics and Viral Culture
Viral Immunodiagnostics:
Stanford Respiratory Virus Testing Algorithm |
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Viral Culture:
While the direct viral exam is relatively rapid, other methods of viral diagnosis, including viral culture and viral nucleic acid amplification testing (see the molecular virology page), are more sensitive. Viral culture may be particularly useful in cases with a broad viral differential as this technique provides a relatively unbiased approach to the identification of viral pathogens. Viral culture utilizes a series of primary cell lines (Human Fibroblast, Rhesus Monkey Kidney) and continuous cell lines (A549 Human Lung Carcinoma) selected for their ability to support the replication of a wide variety of clinically relevant viruses. Specimens are inoculated onto these cell culture monolayers and monitored by light microscopy for cytopathic effect (CPE), the visible cellular changes that occur in response to viral infection.
Based on the specimen source, the time to CPE, the quality of the CPE, and the cell line(s) showing CPE, a preliminary identification can be made. The presence of a specific virus is confirmed by immunofluorescent staining using virus-specific, fluorescently-labeled antibodies. Utilizing viral culture, our laboratory is able to isolate many important pathogenic viruses (including HSV, VZV, cytomegalovirus (CMV), adenovirus, enterovirus, influenza virus, RSV, parainfluenza virus, and rhinovirus) from essentially any source (respiratory, urine, stool, amniotic fluid, tissue, etc.). To expedite the identification of slowly replicating viruses (for example, CMV) we also perform shell vial assays, a modification of traditional viral culture where cells are stained prior to the development of CPE.