Test ID: DENGC Dengue Virus, Molecular Detection, PCR, Spinal Fluid
Ordering Guidance
The presence of dengue virus nucleic acid in cerebrospinal fluid (CSF) or serum (as detected by molecular assays [This test or DENGS / Dengue Virus, Molecular Detection, PCR, Serum] overlaps with the presence of dengue virus nonstructural protein 1 (NS1) antigen (DNSAG / Dengue Virus NS1 Antigen, Serum). Patients with a history of symptoms for more than 1 week may be negative by molecular tests (ie, real-time PCR) and may require serologic testing (DENVP / Dengue Virus Antibody/Antigen Panel, Serum) to confirm the diagnosis of dengue virus infection.
Specimen Required
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Preferred: 12 x 75-mm screw cap vial
Acceptable: Sterile screw cap vial
Container/Tube: Sterile vial
Specimen Volume: 0.5 mL
Collection Instructions: Do not centrifuge.
Useful For
Aiding in the diagnosis of central nervous system infection caused by dengue virus
Testing Algorithm
See Mosquito-borne Disease Laboratory Testing in Special Instructions.
Special Instructions
Method Name
Real-Time Polymerase Chain Reaction (PCR)
Reporting Name
Dengue Virus, PCR, CSFSpecimen Type
CSFSpecimen Minimum Volume
0.3 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
CSF | Refrigerated (preferred) | 7 days | |
Frozen | 7 days |
Clinical Information
Dengue virus (DV) is a globally distributed flavivirus with 4 distinct serotypes (DV-1, -2, -3, -4) and is primarily transmitted by the Aedes aegypti mosquito, found throughout the tropical and subtropical regions of over 100 countries. DV poses a significant worldwide public health threat with approximately 2.5 to 3 billion people residing in DV endemic areas, among whom 100 to 200 million individuals will be infected and approximately 30,000 patients will succumb to the disease, annually.
Following dengue infection, the incubation period varies from 3 to 7 days and while some infections remain asymptomatic, the majority of individuals will develop classic dengue fever. Symptomatic patients become acutely febrile and present with severe musculoskeletal pain, headache, retro-orbital pain, and a transient macular rash, most often observed in children. Fever defervescence signals disease resolution in most individuals. However, children and young adults remain at increased risk for progression to dengue hemorrhagic fever and dengue shock syndrome, particularly during repeat infection with a new DV serotype.
Detection of DV nucleic acid in cerebrospinal fluid (CSF) is a marker for central nervous system infection caused by this virus. Importantly, the period of time that the virus can be detected in serum and CSF is brief and, therefore, molecular testing should be performed within the first week following onset of symptoms. After this time, serologic testing is the preferred method for diagnosis of DV infection.
Reference Values
Negative
Interpretation
Positive:
The detection of dengue virus nucleic acid in cerebrospinal fluid (CSF) is consistent with acute-phase infection of the central nervous system.
Dengue virus nucleic acid may be detectable during the first 1 to 7 days following the onset of symptoms.
Negative:
The absence of dengue nucleic acid in CSF is consistent with the lack of acute-phase infection.
Dengue virus nucleic acid may not be detected if the CSF specimen is collected immediately following dengue virus infection (<24-48 hours) and is rarely detectable following 7 days of symptoms.
Clinical Reference
1. Bhatt S, Gething PW, Brady OJ, et al: The global distribution and burden of dengue. Nature 2013;496:504-507
2. Dengue--an infectious disease of staggering proportions. Lancet 2013 Jun 22;381(9884):2136
3. Rigau-Perez JG, Clark GG, Gubler DJ, et al: Dengue and dengue haemorrhagic fever. Lancet 1998;352:971-977
4. Tang KF, Ooi EE: Diagnosis of dengue: an update. Expert Rev Anti Infect Ther 2012;10:895-907
5. Guzman MG, Kouri G: Dengue diagnosis, advances and challenges. Int J Infect Dis 2004;8:69-80
Day(s) Performed
Tuesday, Thursday
Report Available
5 to 8 daysTest Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87798
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
DENGC | Dengue Virus, PCR, CSF | 77958-7 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
606371 | Dengue Virus, PCR, CSF | 77958-7 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244)with the specimen.
mml-mosquitoborne