How Helpful Is Routine Viral Culture of CSF?

A large retrospective review suggests that, in most cases, PCR is good enough.

For decades, the standard protocol for diagnosing viral infections of the central nervous system (or clarifying any mysterious neurologic illness) has included routine viral culture. However, in recent years, PCR testing has emerged as a rapid, accurate way to diagnose many common viral infections of the central nervous system. Is there any point in continuing to order viral cultures?

Researchers at a Utah reference laboratory reviewed viral culture results of 22,394 cerebrospinal fluid specimens submitted from all parts of the country between 1994 and 2005. Of the 1270 samples (5.7%) from which virus was recovered, more than 99% yielded enterovirus (98.4%) or herpes simplex virus (HSV; 1.3%). Among 929 samples also analyzed with PCR for ent…

Reviewing Author

Abigail Zuger, MD