Polymerase Chain Reaction Is More Sensitive than Viral Culture and Antigen Testing for the Detection of Respiratory Viruses in Adults with Hematological Cancer and Pneumonia

van Elden, Leontine J. R.; van Kraaij, Marian G. J.; Nijhuis, Monique; Hendriksen, Karin A. W.; Dekker, Ad W.; Rozenberg-Arska, Maja; van Loon, Anton M.

We retrospectively analyzed the value of polymerase chain reaction (PCR) for the detection of respiratory viral infections in 43 patients with hematological cancer whose bronchoalveolar lavage (BAL) samples had been stored. In addition, 17 nose-throat (NT) swabs and 29 blood samples had been obtained. PCR was performed to detect parainfluenza viruses 1–3, respiratory syncytial virus, rhinovirus, influenza viruses A and B, enteroviruses, and coronaviruses. Viral cultures or antigen testing of BAL samples revealed 9 respiratory viruses in 8 patients. By use of PCR, 8 more respiratory viruses were detected in another 7 patients, increasing the rate of identification from 19% to 35% (P < .0005). Available NT swabs yielded the same results with PCR as did BAL samples. We conclude that PCR is more sensitive than viral culture or antigen or serologic testing for detection of respiratory viruses in patients with hematological malignancies, and that it offers the possibility for early, more rapid diagnosis.