The diagnosis of viral respiratory disease in older adults.

The diagnosis of viral respiratory disease in older adults.
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DOI:
10.1086/650486
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发表时间:
2010-03-01
期刊:
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子:
--
通讯作者:
Falsey AR
Falsey AR
中科院分区:
其他
文献类型:
--
作者:
Talbot HK;Falsey AR

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老年人的病毒性呼吸道疾病越来越被认为是住院和死亡的重要原因。不幸的是,由于许多病毒性呼吸道病原体在老年人中的感染的识别和诊断可能是难以捉摸的,因为在这个人群中的非典型临床表现和目前的实验室诊断测试的不敏感性。对于流感诊断,快速抗原检测,然后进行病毒培养(如果抗原检测结果为阴性),只要临床医生注意检测的局限性,对老年人可能是有用的。尽管特异性,快速抗原检测在这一人群中不敏感。错误的阴性结果可能导致延迟及时给予抗病毒治疗和适当的隔离预防措施。新的、快速的和敏感的分子诊断方法,如聚合酶链反应检测,将在不久的将来为老年人的病毒性呼吸道感染提供更准确和及时的诊断。
Viral respiratory disease in older adults has been increasingly recognized as a significant cause of hospitalizations and death. Unfortunately, the recognition and diagnosis of infection due to many viral respiratory pathogens in older adults can be elusive because of atypical clinical presentations and the insensitivity of current laboratory diagnostic tests in this population. For influenza diagnosis, rapid antigen tests followed by viral culture (if antigen test results are negative), can be useful in older adults as long as clinicians are mindful of test limitations. Although specific, rapid antigen tests are insensitive in this population. Erroneous negative results may lead to delays in timely administration of antiviral treatment and institution of appropriate isolation precautions. The increasing availability of new, rapid, and sensitive molecular diagnostics, such as polymerase chain reaction testing, should provide more accurate and timely diagnoses of viral respiratory infections in older adults in the near future.
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