The laboratory evaluation of opportunistic pulmonary infections

James H. Shelhamer, Vee J. Gill, Thomas C. Quinn, Stephen W. Crawford, Joseph A. Kovacs, Henry Masur, Frederick P. Ognibene

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


The patient population at risk for opportunistic pulmonary infections has increased during the last decade. The spectrum of organisms causing opportunistic infections has also grown. With an ever broader list of potential therapeutic options and a growing differential diagnosis, a specific diagnosis of the cause of pulmonary disease becomes more important. Recent microbiologic advances have helped to facilitate the laboratory diagnosis of some of these agents. Immunoassays are available for the detection of antigen in nasopharyngeal secretions (respiratory syncytial virus, influenza), in serum (Cryptococcus species), and in urine (Legionella or Histoplasma species). Rapid-culture techniques are available for the culture and detection of various viruses, including cytomegalovirus. Molecular probes can now assist in the rapid identification of Mycobacterium tuberculosis and some fungi. In the near future, polymerase chain reaction- based techniques may assist in the detection of Pneumocystis carinii and Legionella, Chlamydia, Mycoplasma, and Mycobacteria species. An expeditious evaluation of pulmonary disease requires an understanding of the differential diagnosis of likely causes of pulmonary disease in specific immunosuppressed patient populations, an understanding of the most appropriate specimens to process for these diagnoses, and an understanding of the limitations (sensitivity and specificity) of these diagnostic tests. An understanding of the most appropriate specimens and tests in a given institution should allow for early, relatively specific treatment of many potentially life-threatening infections.

Original languageEnglish (US)
Pages (from-to)585-599
Number of pages15
JournalAnnals of internal medicine
Issue number6
StatePublished - Mar 15 1996
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine


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