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Test Code DENGC Dengue Virus, Molecular Detection, PCR, Spinal Fluid


Advisory Information


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: Aliquot Tube, 5 mL (T465)

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.


Secondary ID

606371

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.

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Reporting Name

Dengue Virus, PCR, CSF

Specimen Type

CSF

Specimen Minimum Volume

0.3 mL

Specimen Stability Information

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

Reject Due To

Heat-inactivated specimen Reject

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) and Time(s) Performed

Tuesday, Thursday; 2 pm.

Analytic Time

5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test 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 U.S. Food and Drug Administration.

CPT Code Information

87798

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DENGC Dengue Virus, PCR, CSF 94426-4

 

Result ID Test Result Name Result LOINC Value
606371 Dengue Virus, PCR, CSF 94426-4