Bronchoalveolar lavage (BAL)
Keep specimen at 4C
Bronchoalveolar lavage specimens, bronchial washings, nasal washings, and tracheal aspirates may be submitted. Collection of COMBINED THROAT AND NASOPHARYNGEAL SWABS is recommended for patients in which lavages, aspirates or washings cannot be readily obtained. Immediately transport specimens to the Clinical Virology Laboratory. If an extended delay in transport of specimens is anticipated, rapidly freeze the specimens to at least -60°C and transport to the laboratory on dry ice. Please consult the laboratory if necessary.
Swab specimens not received in viral transport medium or received in bacteriological transport medium are discouraged. DO NOT USE CALCIUM ALGINATE OR WOODEN SHAFT SWABS FOR COLLECTION OF SPECIMENS; ONLY USE DACRON OR RAYON TIPPED SWABS ON PLASTIC OR METAL SHAFTS.
Amplification and detection of EBV DNA of the nonglycosylated membrane protein BNRF1 p143 gene using TaqMan real-time PCR technology. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
If positive, results are reported as Epstein-Barr virus DNA detected.
Negative or no Epstein-Barr virus DNA detected
Clinical Utility: EBV is the primary cause of infectious mononucleosis with symptoms of fever, exudative pharyngitis, lymphadenopathy, enlarged liver and spleen, and an atypical lymphocytosis. Infections with EBV can lead to hepatitis, pneumonia, myocarditis, neurologic syndromes, hemolytic anemia, thrombocytopenia, and hemophagocyctic syndrome. The virus is also associated with posttransplantation lymphoproliferative disorders (PTLD), Burkitt lymphoma, X-linked lymphoproliferative syndrome, nasopharyngeal carcinoma, and lymphomas of the CNS. The diagnosis of EBV infection is increasingly being made by PCR, and EBV DNA has been detected in specimens from solid-organ and bone marrow transplant recipients and HIV-infected patients with lymphoproliferative disorders; individuals with infectious mononucleosis, and in patients with other manifestations of primary or recurrent EBV infections. Quantitative PCR assays should be used in immunocompromised patients to associate infection with disease, predict and monitor disease progression, assess efficacy of antiviral therapy, and to facilitate our understanding of the pathogenesis of EBV. In these patients, viremia is considered to be the best predictor of disease, and quantitative measures of EBV DNA in blood is useful for the continued surveillance and management of transplant patients.