ABSTRACT
BACKGROUND/PURPOSE: Rapid diagnosis of influenza was important in the global pandemic influenza A/H1N1 outbreak. The QuickVue Influenza A+B test is one of the most common tests for rapid diagnosis of influenza. We evaluated the sensitivity and specificity of the test in children. METHODS: We collected data from 970 patients with influenza-like illness who received rapid influenza antigen tests using the QuickVue Influenza A+B test as well as viral isolation. We compared the results with that of viral isolation and reverse-transcriptase polymerase chain reaction (RT-PCR) assays. RESULTS: Based on viral culture, the QuickVue Influenza A+B test had an overall sensitivity of 0.82 (419/513) and specificity of 0.99 (70/71), with a positive predictive value (PPV) of 0.74 (419/563) and a negative predictive value (NPV) of 0.77 (313/407). The sensitivity of QuickVue was significantly higher in specimens with high viral loads. If the viral loads were less than 10(6), the sensitivity of QuickVue was 0.62, while the sensitivity of QuickVue was 0.88 if the viral loads were higher than 10(6) (p<0.001). Logistic regression analysis showed that higher viral loads correlated with positive QuickVue results (p<0.001). On the first day of fever, the sensitivity of QuickVue was only 0.67; on the second day, the sensitivity was 0.86; on the third day, the sensitivity was 0.98, and on the fourth day, the sensitivity was 0.90. The sensitivity is significantly higher on days 2-3 in comparison with the first day of fever (p<0.05). We calculated the correlation of viral load and fever days, and the result showed higher mean viral load on the second and third days of fever. Age did not affect the sensitivity. CONCLUSION: In children, the sensitivity of QuickVue Influenza A+B test was 0.82. In addition, the sensitivity was significantly elevated in the higher viral load group and on the third day of fever.
Subject(s)
Antigens, Viral/isolation & purification , Influenza A Virus, H1N1 Subtype/immunology , Influenza, Human/diagnosis , Reagent Kits, Diagnostic , Adolescent , Adult , Child , Female , Humans , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/epidemiology , Influenza, Human/virology , Logistic Models , Male , Middle Aged , Pandemics , Prospective Studies , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and Specificity , Taiwan/epidemiology , Viral Load , Young AdultABSTRACT
BACKGROUND/PURPOSE: Human papillomavirus (HPV) infection can cause laryngeal papillomas in children. Vertical transmission has been confirmed. This study aimed to establish a sensitive molecular diagnostic method and understand the incidence of the HPV-6 and HPV-11 in neonates with intubation. METHODS: We enrolled 108 newborns between October 2007 and January 2010. All neonates were intubated due to underlying disease. The specimens were collected via endotracheal aspiration. DNA of HPV types 6 and 11 was detected by real-time PCR and nested PCR. RESULTS: HPV-DNA was detected in eight of the 108 newborns studied. Seven respiratory specimens tested positive for HPV-11 and one was positive for HPV-6. The HPV 6/11 detection rate in neonates was 7.4% (8/108). CONCLUSION: A rapid, sensitive, specific, and reproducible RT-PCR method and nest PCR were developed for the detection and differentiation of HPV-6 and HPV-11 genomic variants in a single PCR reaction. The assays are of great value for clinical and epidemiologic studies of HPV-6 and HPV-11 infections. Neonatal HPV colonization may be related to juvenile-onset recurrent respiratory papillomatosis. The transmission route may be from mother to child. The clinical significance of neonatal carriage of HPV-6 or HPV-11 warrants further study.
Subject(s)
Human papillomavirus 11/isolation & purification , Human papillomavirus 6/isolation & purification , Molecular Diagnostic Techniques/methods , Papillomavirus Infections/virology , Academic Medical Centers , Base Sequence , Cohort Studies , DNA, Viral/analysis , DNA, Viral/isolation & purification , Human papillomavirus 11/genetics , Human papillomavirus 6/genetics , Humans , Incidence , Infant, Newborn , Intubation, Intratracheal/statistics & numerical data , Molecular Sequence Data , Pilot Projects , Reproducibility of Results , Reverse Transcriptase Polymerase Chain Reaction/methods , Sensitivity and Specificity , Sequence AlignmentABSTRACT
Natural killer (NK) cell lymphoma of lung is very rare. We report a case of NK cell lymphoma presented in a 17-year-old male with bilateral pleural effusions and hemophagocytic lymphohistocytosis. Morphologic and immunohistochemical tests revealed an association of NK cell lymphoma with Epstein-Barr virus. A literature review helped identify other cases of patients with NK cell lymphoma, their treatment and outcomes.
