Which diagnostic techniques are used in the diagnosis of viral pneumonia?

Updated: Mar 24, 2021
  • Author: Zab Mosenifar, MD, FACP, FCCP; Chief Editor: John J Oppenheimer, MD  more...
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Answer

Over the past decade, developments in diagnostic techniques have led to a significant improvement in the ability to detect viruses in the respiratory tract. However, the detection of viral pathogens does not always indicate active disease. For example, herpesviruses may become reactivated without causing significant active disease. Similarly, respiratory syncytial virus (RSV) and cytomegalovirus (CMV) can be detected in the presence of other known bacterial pathogens.

In most circumstances, virologic tests are the mainstay of precise etiologic diagnosis. Rapid antigen detection kits can provide results within hours, making them useful in the emergency department. The sensitivity and specificity of these kits varies between 80% and 95%. See Table 1.

Table 1. Diagnostic Techniques Used for Viral Pneumonia (Open Table in a new window)

Virus

Viral Culture

Cytologic Evaluation

Rapid Antigen Detection

Gene Amplification

Influenza virus

HAa, SVb

 

IFc, ELISAd

RT-PCRe

Adenovirus

CEf, SV

Intranuclear inclusions

IF, ELISA

RT-PCR

Paramyxoviruses

Respiratory syncytial virus

CE, SV

Eosinophilic cytoplasmic inclusions

IF, ELISA

RT-PCR

Parainfluenza virus

HA, SV

Eosinophilic intranuclear inclusions

IF, ELISA

RT-PCR

Measles virus

HA

 

 

 

Herpes viruses

Herpes simplex virus

CE, SV

Cytoplasmic inclusions

IF, ELISA

PCR

Varicella-zoster virus

CE

Cytoplasmic inclusions

IF

RT-PCR

Cytomegalovirus

CE, SV

"Owl's eye" cells

IF, ELISA

RT-PCR

Hantavirus

 

 

Antibodies against FCVg

FVC RNA by RT-PCR

a HA - Hemaglutination

b SV - Shell viral culture

c IF - Immunofluorescence

d ELISA - Enzyme-linked immunosorbent assay

eRT-PCR - Reverse transcriptase polymerase chain reaction

fCE - Cytopathogenic effects

gFCV - Four corners virus


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