[Should the development of virological diagnostic methods influence our practical approach?].
Respiratory viral infections which occur in patients with spontaneous or therapeutic immunodepression are frequent and serious. Apart from these acute situations, viruses are responsible for some chronic respiratory pathologies which affect the functional prognosis, as illustrated by the relationship between the respiratory pathologies demands an accurate diagnosis. Two methods can be used routinely to demonstrate the presence of a virus in bronchoalveolar lavage fluid or in transbronchial biopsy: (1) direct immunofluorescence or immunoenzymatic technique; the concomitant finding of a cytopathogenic effect on the cells that constitute the sample makes this method more sensitive and confirms the pathogenic character of viruses demonstrated by immunological techniques; (2) isolation of the virus from cell cultures; the sensitivity of this method can be increased by an immunological search for the virus (fast culture). Hybridization in situ is a new and promising method where a DNA probe complementary to viral nucleic acids is used to evidence the viral genome in the infected cells. Serum IgM assays, which provide proof of an active infection, should be preferred to conventional serology, although seroconversion is inconstant in immunodepressed patients. Improvements in virological diagnostic methods should result in the future use of new antiviral treatments.
Pujol
J L
JL
Service des Maladies respiratoires, Hôpital de l'Aiguelongue, Montpellier.
Barneon
G
G
Michel
F B
FB
Godard
P
P
D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000032:analysis; D001999:Bronchoscopy; D015342:DNA Probes; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D007159:Immunologic Tests; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D014777:Virus Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology
D015342:DNA Probes
L'évolution des moyens diagnostiques en virologie doit-elle modifier notre attitude pratique?