Herpes simplex viruses & Varicella-zoster virus - detection

Plasma:
○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood in appropriate container
○ neonates: a minimum of 0.5 mL; if ordered as part of a TORCH screen, 2.5 mL of blood is sufficient for all serology tests
BAL
○ Pass bronchoscope transnasally or transorally (if patient is not intubated) or via endotracheal tube (if patient is intubated). Instill a large volume of 0.85% sterile saline (nonbacteriostatic) into the airway lumen. Discard the initial fluid recovered (likely contaminated). Collect approximately remaining fluid in a clean, sterile container via suction.

CSF
○ Decontaminate skin, collect at least 0.5 mL of CSF by lumbar puncture into sterile container

Corneal scraping
○ Corneal surfaces should be rinsed thoroughly with normal saline to remove anaesthetic prior to collecting specimen
○ Use a Kimura scalpel to scrape across the ulcer using short firm strokes in one direction. Obtain 3 to 5 scrapings per cornea. Avoid contact with eyelids/eyelashes. Place scrapings into viral transport media

Conjunctival or vesicle/lesion swab
○ Conjunctival surfaces should be rinsed thoroughly with normal saline to remove anaesthetic prior to collecting specimen. Roll a sterile pre-moistened swab over the conjunctiva and place in transport medium
○ For lesions/vesicles, de-roof vesicle to remove crust and swab to express serous exudate.

Oral washings
○ Rinse mouth with small amount of saline ensuring to swish and gargle with solution. Collect saliva and washings in sterile container

Other sterile body fluids or tissues
○ Collect body fluids or tissues via fine needle aspiration, punch biopsy of lesion and place in sterile container