Adenovirus PCR - stool specimen
- LIS Mnemonic: ADENOPCR
Collect
stool in a sterile, leak-proof container
Volume Required
2-4 ml of liquid stool; 2 to 4 grams of formed stool
Minimum Required
2 ml of liquid stool; 2 grams of formed stool
Transport
Keep specimen at 4C
Processing
The specimen of choice is stool. Rectal swabs are inferior to stool specimens for the detection of adenoviruses and are strongly discouraged. If it is necessary to collect a rectal swab, a sufficient quantity of fecal material (at least a pea-sized amount) should be obtained. If fecal material is not clearly visible on the swab, the specimen is most likely inadequate. Rectal swabs should be immediately placed in Viral Transport Medium. All specimens should be refrigerated immediately after collection and during storage and transport. 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.
Unacceptable conditions
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.
Days Performed
Daily
Reported
Same day
Reflex Testing
N/A
CPT
87798
Methodology
Amplification and detection of adenovirus DNA using real-time TaqMan PCR and nucleic acid primer/probe pairs specific for conserved regions of the adenovirus genome. Detects all 51 known serotypes of adenoviruses; does not differentiate by type. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
Interpretation
If positive, results are reported as adenovirus DNA detected.
Reference Values
Negative or no adenovirus DNA detected
Remarks
Clinical Utility: RESPIRATORY: Adenoviruses are important causes of acute upper and lower respiratory tract illnesses in immunocompetent infants and children. Manifestations include the common cold, pharyngitis, tonsillitis, conjunctivitis, pharyngoconjuntival fever, croup, a pertussis-like syndrome, bronchiolitis, and pneumonia. OCULAR: Adenoviruses are commonly associated with acute follicular conjunctivitis and pharyngoconjunctival fever, and less frequently with epidemic keratoconjunctivitis (occurs mainly in adults) in immunocompetent individuals. GASTROINTESTINAL: The fastidious adenovirus types 40 and 41 can cause viral gastroenteritis. These adenovirus types are widespread and cause endemic diarrhea and outbreaks of diarrhea; infections appear to occur year-round. DISSEMINATED INFECTIONS: Adenoviruses can cause life-threatening disseminated infections in young infants and immunocompromised hosts such as bone marrow, liver, kidney, and lung transplant recipients and patients with primary immunodeficiency disorders, AIDS or malignancies. Clinical manifestations of adenovirus disease in immunocompromised patients include pneumonia, hepatitis, nephritis, colitis, encephalitis, hemorrhagic cystitis, and myocarditis. Detection of adenovirus DNA in blood plasma is useful for identifying immunocompromised patients at risk for invasive disease. Depending on the particular patient and specific disease, other specimens may be submitted as well. These include bone marrow, tissue (e.g., liver, lung, kidney, colon, endomyocardial biopsy), CSF, urine, respiratory, conjunctival, and stool.
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