Virology ordering guidelines based upon specimen type and possible symptoms.
| Specimen Type | Possible Symptoms | Suspect Agents | DFA Testing | Suggested Test | Acceptable Specimens |
| Amnionic Fluids | Failure to thrive, Intrauterine growth retardation (IUGR), miscarriage | Cytomegalovirus (CMV), enterovirus, Herpes simplex virus (HSV), varicellazoster virus (VZV), rubella virus | None | CVC | Amniotic fluids in sterile container. |
| Blood Bone Marrow Bone Marrow Biopsy | Fever of unkown origin, AIDS, ARC | CMV, enterovirus, HSV, measles, mumps, VZV | None | CVC | Blood or bone marrow in heparin (green top) or EDTA (purple top) tubes.Tissues in sterile saline. |
| Broncho- alveolar Lavage | Pneumonia, respiratory distress | Adenovirus, Chlamydia pneumoniae, Chlamydia psittaci, CMV, HSV, VZV, enteroviruses, influenza, measles, parainfluenza, respiratory syncytial virus (RSV), rhinovirus | RVDRSV (RSV) | RVC | Bronchoalveolar lavage/wash in sterile leak-proof container. |
| Cerebrospinal Fluid (CSF)Brain Biopsies | Meningitis, encephalitis, fever, confusion, drowsiness, convulsions | Adenovirus, CMV, enteroviruses, HSV, mumps, measles, rubella, VZV | None | CVC | Submit at least 1 mL of CSF.Brain biopsies in sterile saline. |
| Dermal Lesions | Vesicular or maculopapular rash, lesions, fever, chickenpox, shingles | Adenovirus, VZV, enteroviruses, HSV | DVDHSVD (HSV)VZD (VZV) | DVCCVC (enterovirus or adenovirus)HSVC(herpes) VZVC (VZV only) | Vesicle fluid, swab of lesion, and basal cell scraping (all three in the same vial is preferred). |
| Fecal SpecimenRectal Swab | Fever, headache, malaise, meningitis, diarrhea, vomiting, cold, Bornholm disease | Enteroviruses, poliovirus, adenovirus, rotavirus, Clostridium difficile toxin, HSV (rectal swab) | HSVD (HSV) | CVC | Stool in clean container or Cary Blair medium. Do not use fixatives or preservatives.Rectal swab in viral transport medium. |
| Ocular Specimens | Pain and swelling of eyelids, ocular discharge, uveitis, conjunctivitis, keratitis, acute hemorrhagic conjunctivitis | Adenovirus, Chlamydia trachomatis, CMV, enteroviruses, HSV, VZV | CDF (Chlamydia) | CVCCHC (Chlamydia culture)DVC (HSV & VZV)HSVC (HSV) VZVC (VZV) | Conjunctival swabs or scrapings in viral transport medium.Aqueous or vitreous fluids; vitreous washings; or corneal biopsy specimens in viral transport medium. |
| Products of Conception | Failure to thrive, IUGR, miscarriage | CMV, enterovirus, HSV, virus VZV, rubella virus. | None | CVC | Tissues in sterile saline. |
| Respiratory Specimens | Bronchitis/ bronchiolitis, cold, croup, influenza syndrome, pneumonia/ pneumonitis, sinusitis, otitis media | Adenovirus, Chlamydia pneumoniae, Chlamydia psittaci, CMV, enteroviruses, HSV, influenza, measles, parainfluenza, respiratory syncytial virus (RSV), rhinovirus, VZV | RVDCDF | RVCCHC (Chlamydia culture) | Nasopharyngeal swab and a throat swab in one tube of viral transport medium (preferred).Nasal washes in sterile tube or cup.Nasal aspirates in Lukens trap.Throat swabs in viral transport medium (low yield when submitted without an NP swab)Tissues in sterile saline |
| Urine | Cystitis, urethritis, viral exanthem, dysuria, urethral discharge, cytomegalic inclusion disease | Adenovirus, Chlamydia trachomatis, CMV, measles, mumps, polyomaviruses, Neisseria gonorrhoeae | CVCCHLCR (Chlamydia)GCLCR (gonorrhoeae) | First void urine is preferred for chlamydia and gonorrhoea.Random urine or catherized urines may be used for culture.Urine specimens must be submitted in clean containers with no preservatives. | |
| Urogenital Specimens | Urethritis, cervicitis, lesions, vaginal or urethral discharge, painful urination, PID, vesicular lesion | Adenovirus, CMV, HSV, mumps, Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus (HPV) | HSVD (lesion)CHFChlamydia trachomatis | HSVC(herpes)CHC (Chlamydia culture)CVC (viruses other than HSV)CHLCR (Chlamydia)GCLCR HPV | Urethral swab, cervical swab or brush, lesion scraping in viral transport for culture.Cervical or urethral swab in Abbott UriProbe transport tube for LCR assay.Cervical brushings for HPV in Digene transport or ThinPrep vial. |