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Test ID: HSVC Herpes Simplex Virus (HSV), Molecular Detection, PCR, Spinal Fluid

Useful For

Aids in the rapid diagnosis of herpes simplex virus (HSV)-1 and HSV-2 infections of the central nervous system

Method Name

Real-Time Polymerase Chain Reaction (RT-PCR)

Reporting Name

Herpes Simplex Virus, PCR, CSF

Specimen Type


Specimen Required

Supplies: Sarstedt 5 mL Aliquot Tube (T914)

Container/Tube: Aliquot tube

Specimen Volume: 0.2 mL

Collection Instructions: Do not centrifuge or heat-inactivate.

Additional Information:

1. The high sensitivity of amplification by PCR requires the specimen to be processed in an environment in which contamination of the specimen by herpes simplex virus DNA is not likely.

2. Specimens that are received with less than the minimum volume required for all testing requested will be canceled.

Specimen Minimum Volume

0.1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 7 days
  Frozen  7 days

Clinical Information

Herpes simplex virus (HSV)-1 and HSV-2 are members of the Alpha herpesviridae subfamily. HSV is an enveloped virus with a capsid containing viral DNA. Although HSV-1 and HSV-2 are closely related, the 2 viruses are serologically and genetically distinct.(1,2)


HSV-1 and -2 are common causes of dermal and genital infections; however, in some cases, infection with HSV may result in central nervous system (CNS) disease that is considered a medical emergency. HSV infection of the CNS may result in encephalitis (more commonly associated with HSV-1) or meningitis (more commonly associated with HSV-2).


Encephalitis is inflammation of the brain associated with clinical evidence of neurologic dysfunction. Of the pathogens reported to cause encephalitis, the majority are viruses.(3) In general, the most commonly identified etiologies in the United States are HSV, West Nile virus, and the enteroviruses, followed by other herpesviruses.(3)


HSV causes about 5% to 10% of all encephalitis cases, and is one of the most common causes of identified sporadic encephalitis globally.(3) HSV encephalitis occurs in all ages, and during all seasons. HSV-1 encephalitis is more common in adults, and HSV-2 encephalitis is more common in neonates.(3) One study reported a neonatal herpes rate of 1 case per 3,200 live births in the United States.(4)


Clinical features involved with HSV encephalitis include fever, hemicranial headache, language and behavioral abnormalities, memory impairment, and seizures.(3)

Reference Values



A positive result suggests the presence of herpes simplex virus (HSV)-1 and/or HSV-2 DNA in the cerebrospinal fluid (CSF) sample.


A negative result suggests that HSV-1 and HSV-2 DNA are not present in the CSF sample.


An invalid result points to the inability to determine presence or absence of HSV-1 or HSV-2 DNA in the CSF sample.

Clinical Reference

1. Lawrence C: Herpes Simplex virus. In Principles and Practice of Infectious Diseases. Sixth Edition. Edited by GL Mandell, JE Bennet, R Dolin. Philadelphia, Elsevier, Churchill and Livingstone, 2004, pp 1762-1780

2. Szpara ML, Parsons L, Enquist LW: Sequence variability in clinical and laboratory isolates of herpes simplex virus 1 reveals new mutations. J Virol 2010;84(10):5303-5313

3. Tunkel AR, Glaser CA, Bloch KC, et al: The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2008 Aug 1;47(3):303-327

4. Brown ZA, Wald A, Morrow RA, et al: Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA 2003;289(2):203-209

5. Clinical Management Guidelines for Obstetrician-Gynecologists. ACOG Practice Bulletin No. 57, 104 (5 pt 1). 2004;1111-1118

6. Binnicker MJ, Espy MJ, Irish CL: Rapid and direct detection of herpes simplex virus in cerebrospinal fluid using a commercial real-time PCR assay. J Clin Microbiol 2014 Oct 1. PMID 25274992

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 to 2 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87529 x 2

87999 (if appropriate for government payers)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HSVC Herpes Simplex Virus, PCR, CSF 92865-5


Result ID Test Result Name Result LOINC Value
36858 HSV 1 PCR, C 16952-4
36859 HSV 2 PCR, C 16960-7

Testing Algorithm

See Meningitis/Encephalitis Panel Algorithm in Special Instructions.


If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information: