Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect
CPT4 code
Name of the Procedure:
Virus Isolation; Tissue Culture Inoculation, Observation, and Presumptive Identification by Cytopathic Effect
Common names: Virus culture, Cytopathic effect virus identification
Summary
This procedure involves isolating a virus from a sample by growing it in cultured cells, then watching for changes (cytopathic effects, or CPE) in the cells that indicate viral infection. It helps identify the presence and type of virus causing an illness.
Purpose
The main goal is to detect and identify viruses from clinical samples such as blood or tissue. It is critical for diagnosing viral infections and planning appropriate treatment.
Indications
- Persistent or unexplained viral symptoms
- Suspected viral infections like herpes simplex, influenza, or enterovirus
- Confirming viral infection after initial screening tests
- Special cases where other diagnostic methods are inconclusive
Preparation
- Generally, no special preparation like fasting is needed.
- The sample may need to be collected at a particular stage of infection.
- Explain the procedure and obtain consent.
Procedure Description
- Sample Collection: Obtain a clinical sample (e.g., swab, blood, tissue).
- Inoculation: Introduce the sample to cultured cells in a laboratory setting.
- Incubation: Maintain the cultured cells under conditions favorable for viral growth.
- Observation: Monitor cells for CPE, such as cell death, fusion, or detachment.
- Identification: Based on observed CPE, make a presumptive identification of the virus.
Tools and Equipment
- Cell cultures (e.g., Vero, HeLa cells)
- Incubators
- Microscopes
- Sterile lab supplies
Anesthesia or Sedation
- Not applicable
Duration
The entire process, from sample inoculation to final observation, can take several days to a couple of weeks.
Setting
Performed in a specialized hospital laboratory or research facility.
Personnel
- Medical technologists/technicians
- Microbiologists
- Pathologists
Risks and Complications
- Generally low risk for the patient
- Rarely, sample collection (e.g., biopsy) might cause minor discomfort or infection
Benefits
- Accurate detection and identification of viruses
- Helps guide effective treatment plans
- Understand the epidemiology of viral outbreaks
Recovery
- No recovery needed from the isolation procedure itself.
- Follow-up may depend on initial sample collection (e.g., biopsy site care).
Alternatives
- Polymerase Chain Reaction (PCR): Faster and highly specific but may not detect all virus types.
- Serological tests: Can identify past infections but may not pinpoint current infections.
- Antigen tests: Quick but less sensitive.
Patient Experience
- The patient may only experience sample collection, such as a blood draw or swab, which might cause mild discomfort.
- No direct discomfort or pain since the rest of the procedure is lab-based.
- No downtime required.