Viral culture remains the definitive test for the detection of HSV infection outside of the CNS. It has a reported sensitivity of 50% and specificity of nearly 100%.57 The laboratory turn-around time for viral culture is approximately 3 to 7 days.57 When evaluating a neonate for HSV disease, surface viral cultures should be obtained from the mouth, conjunctivae, nasopharynx, and rectum before starting antiviral therapy. Skin lesions and vesicles should also be cultured. However, treatment should be initiated based on clinical suspicion rather than awaiting culture results. Treatment can be tailored, if necessary, based on the results.
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