Approach to diagnostic testing for adenovirus based upon the clinical syndrome

Clinical syndrome	Suggested test(s) for adenovirus if diagnosis is necessary*
Upper respiratory illness	Viral culture if available and/or viral antigen assay on respiratory specimen(s) (eg, nasopharyngeal swab or aspirate; throat swab or wash)
Epidemic keratoconjunctivitis	Viral culture and/or adenovirus-specific antigen assay on conjunctival swab or scraping
Pneumonia	Viral culture or PCR of nasopharyngeal aspirate or swab, throat swab, sputum, tracheal aspirate or BAL material
Prolonged diarrhea in young children	Adenovirus-specific antigen assay on stool specimen
Immunocompromised hosts	Viral culture or PCR of affected sites; quantitative PCR of blood; biopsy if clinically indicated^¶

PCR: polymerase chain reaction; BAL: bronchoalveolar lavage.
* If there is a potential outbreak or an individual patient has a severe manifestation (to make decisions about antiviral therapy, exclude other treatable infections, determine prognosis, and/or initiate infection control measures).
¶ The appropriate diagnostic tests depend upon the severity and site(s) of infection, as well as the degree of immunocompromise.

Graphic 81573 Version 4.0

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Approach to diagnostic testing for adenovirus based upon the clinical syndrome