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Chapter 6 : Specimen Requirements Selection, Collection, Transport, and Processing

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Abstract:

Proper specimen collection is essential for interpreting test results because of the wide range of viruses, the complexity of virus–host interactions, and changes in testing methodology. Some viruses are part of our normal flora and cause no symptoms. Others, such as human herpes virus 6 (HHV-6), can integrate into germ line cells and be transmitted vertically to children (1, 2). Chronic, suppressed, or latent viruses like human immunodeficiency virus (HIV) or BK virus (BKV) can be reactivated to cause transient, low-level viremia that may or may not need clinical attention (3, 4). Asymptomatic shedding can also result in detection of virions for long periods of time (5–7). In order to recognize and interpret infectious episodes, it is crucial for diagnostic laboratories to receive appropriate specimens for viral testing.

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
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Tables

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TABLE 1

Specimen Information for respiratory disease [e.g., pharyngitis, laryngotracheobronchitis (croup), bronchitis, bronchiolitis, pneumonitis]

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 2

Specimen information for exanthems (e.g., maculopapular, diffuse, dermatomal, vesicular)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 3

Specimen information for neurological infections (e.g., meningitis, meningoencephalitis, encephalitis, encephalopathy)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 4

Specimen information for infections with joint pain (e.g., fever, polyarthralgia, polyarthritis, tenosynovitis)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 5

Specimen information for hepatic infections (e.g., jaundice, elevated liver enzymes, dark urine, abdominal pain)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 6

Specimen information for gastroenteritis (e.g., diarrhea, abdominal pain, vomiting)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 7

Specimen information for genital infections (e.g., lesions, atypical squamous cells)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 8

Specimen information for retroviruses

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
Generic image for table
TABLE 9

Specimen information for congenital infections (e.g., intrauterine, perinatal, postnatal)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
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TABLE 10

Specimen information for infectious mononucleosis

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
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TABLE 11

Specimen information for hemorrhagic fevers

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6
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TABLE 12

Specimen information for other infections, like ocular (e.g., conjunctivitis, retinitis, endophthalmitis), heart (e.g., myocarditis, pericarditis), and renal infections (e.g., hemorrhagic cystitis, nephropathy)

Citation: Khare R, Grys T. 2016. Specimen Requirements Selection, Collection, Transport, and Processing, p 57-77. In Loeffelholz M, Hodinka R, Young S, Pinsky B (ed), Clinical Virology Manual, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819156.ch6

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