Respiratory Adenovirus Culture (Rule out)

Definition

Adenovirus respiratory infections most commonly occur in young children and typically present with nonspecific findings of febrile viral respiratory tract infection. Immunocompromised, especially bone marrow transplant, patients may present with severe disease. Respiratory adenovirus infections do not show as strong a seasonal variability (winter months) as the other common respiratory viral pathogens.

This test is used to detect respiratory viral infections caused by adenoviruses. Respiratory specimens for adenovirus are inoculated onto human cell lines; A549, HeLa, HEp-2, and MRC-5 cell lines are commonly used. Tube cultures or shell vial culture technique may be used. A presumptive diagnosis may be made on the basis of typical cytopathic effect and then confirmed by immunologic techniques. Adenovirus detection may be included in virus culture or molecular test panels for respiratory virus detection. Children with respiratory adenovirus infection frequently demonstrate leukocytosis (>15,000/mm3) and increased ESR and CRP, in contrast to the lack of these signs in other common viral respiratory tract infections.
Turnaround time: Most cultures are positive within 2 weeks. Tube cultures may be incubated for up to 4 weeks before signing out as negative. Shell vial cultures are stained within 3 days of incubation.

Specimens should be collected in the first week after onset of symptoms.
Nasopharyngeal swabs or aspirates are recommended; other respiratory tract specimens may be acceptable for culture.
It is recommended that specimens be inoculated into a viral transport medium and transported to the laboratory at 4 ‚ °C.

Submission of specimens >7 days after onset of acute infection is associated with decreased sensitivity.