Acute viral nasopharyngitis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Laboratory findings consistent with diagnosis of acute viral nasopharyngitis include positive viral culture, positive PCR, and leucocytosis. The common cold is diagnosed clinically and lab tests are usually not needed unless identification of the specific rhinovirus strain is necessary.

Laboratory findings

The common cold is diagnosed clinically and lab tests are usually not needed unless identification of the specific rhinovirus strain is necessary.[1]

Viral culture

  • Specimens from nasal discharge can be cultured on embryonic lung cells or M-HeLa cells.
  • Results are available after 14 days, so empiric treatment should be started before the results come in.[2]

PCR

  • PCR is a faster and more sensitive test than viral culture and direct antigen testing.
  • However, PCR is a very expensive diagnostic tool, so its use should be limited to severely ill patients for whom identification of the offending organism is critical.[3]

Other lab tests

CBC

ESR and CRP

  • ESR and CRP may be elevated, but are highly nonspecific.

References

  1. Fleming DM, Ayres JG (1988). "Diagnosis and patterns of incidence of influenza, influenza-like illness and the common cold in general practice". J R Coll Gen Pract. 38 (309): 159–62. PMC 1711327. PMID 3265157.
  2. Wright PF, Deatly AM, Karron RA, Belshe RB, Shi JR, Gruber WC, Zhu Y, Randolph VB (2007). "Comparison of results of detection of rhinovirus by PCR and viral culture in human nasal wash specimens from subjects with and without clinical symptoms of respiratory illness". J. Clin. Microbiol. 45 (7): 2126–9. doi:10.1128/JCM.02553-06. PMC 1933022. PMID 17475758.
  3. van Elden LJ, van Kraaij MG, Nijhuis M, Hendriksen KA, Dekker AW, Rozenberg-Arska M, van Loon AM (2002). "Polymerase chain reaction is more sensitive than viral culture and antigen testing for the detection of respiratory viruses in adults with hematological cancer and pneumonia". Clin. Infect. Dis. 34 (2): 177–83. doi:10.1086/338238. PMID 11740705.

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