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Characterization of the Cytopathic Effects of Monkeypox Virus Isolated from Clinical Specimens and Differentiation from Common Viral Exanthems - PubMed

  • ️Sat Jan 01 2022

Characterization of the Cytopathic Effects of Monkeypox Virus Isolated from Clinical Specimens and Differentiation from Common Viral Exanthems

Angela Ma et al. J Clin Microbiol. 2022.

Abstract

While the practice of viral culture has largely been replaced by nucleic acid amplification tests, circumstances still exist in which the availability of viral culture will allow for the diagnosis of infections not included in a provider's differential diagnosis. Here, we examine the cytopathic effects (CPE) and clinical data associated with 18 cases of monkeypox virus (MPXV) isolated from 19 clinical samples submitted for viral culture. During the study period, a total of 3,468 viral cultures were performed with herpes simplex virus (HSV) most commonly isolated (646/3,468; 18.6%), followed by MPXV (19/3,468; 0.6%) and varicella-zoster virus (VZV) (12/3,468; 0.4%). Most MPXV-positive samples were obtained from males (14/19) and taken from genital (7/19) or rectal lesions (5/19). Cycle threshold values of tested samples ranged from 15.3 to 29.0. Growth of MPXV in cell culture was rapid, yielding detectable CPE at a median of 2 days (range: 1 to 4) often with >50% of the monolayer affected in RMK, BGM, A549, and MRC-5 cell lines. As clinical features of MPXV, HSV, and VZV lesions may overlap, CPE patterns were compared between viruses. HSV CPE developed in a similar time frame (median: 2 days, range: 1 to 7) but was more often negative in RMK cells relative to MPXV. VZV grew more slowly (median: 9 days, range: 5 to 11) and demonstrated CPE affecting ≤25% of cell monolayers when positive. Viral culture remains an important tool for the detection of rare or emerging viral pathogens, particularly when high viral load specimens are easily obtained.

Keywords: MPXV; culture; cytopathic effects; monkeypox virus; viral culture; viral load; virology; virus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIG 1
FIG 1

CPE grade at the time of positive culture for MPXV (A), HSV (B), and VZV (C). CPE graded as follows: 0 = no CPE present, 1+ = ≤25% CPE, 2+ = >25% CPE, 3+ = >50% CPE, 4+ = >75% CPE.

FIG 2
FIG 2

Comparison of uninfected cells with the cytopathic effects of MPXV following 2 days incubation at 37°C, 5% CO2 in RMK (A) and (B), BGM (C) and (D), A549 (E) and (F), and MRC-5 (G) and (H) cell lines. Images taken at ×100 magnification.

FIG 3
FIG 3

Comparison of typical MPXV (A) and (B), HSV1 (C) (D), HSV2 (E) and (F), and VZV (G) and (H) cytopathic effects in A549 and MRC-5 cells. Images taken at ×200 magnification.

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