Direct Detection of Epstein-Barr Viral Antigen in Nasopharyngeal Swabs from Patients with Infectious Mononucleosis
Corresponding Author
Nathan D. Bills PhD
Department of Pathology and Microbiology (NDB. SHH). Eppley Institute for Research in Cancer and Allied Diseases (SHH), and Department of Surgery (JWM). Current affiliation: Sr. Luke's Hospital, Bethlehem, PA, Department of Emergency Medicine (JWM).
Department of Pathology and Microbiology, 600 South 42nd Street, University of Nebraska Medical Center Omaha, NE 68198–4495, Fax: 402–559–4077: e-mail: [email protected]Search for more papers by this authorSteven H. Hinrichs MD
Department of Pathology and Microbiology (NDB. SHH). Eppley Institute for Research in Cancer and Allied Diseases (SHH), and Department of Surgery (JWM). Current affiliation: Sr. Luke's Hospital, Bethlehem, PA, Department of Emergency Medicine (JWM).
Search for more papers by this authorJeffrey W Morse MD, MS
Department of Pathology and Microbiology (NDB. SHH). Eppley Institute for Research in Cancer and Allied Diseases (SHH), and Department of Surgery (JWM). Current affiliation: Sr. Luke's Hospital, Bethlehem, PA, Department of Emergency Medicine (JWM).
Search for more papers by this authorCorresponding Author
Nathan D. Bills PhD
Department of Pathology and Microbiology (NDB. SHH). Eppley Institute for Research in Cancer and Allied Diseases (SHH), and Department of Surgery (JWM). Current affiliation: Sr. Luke's Hospital, Bethlehem, PA, Department of Emergency Medicine (JWM).
Department of Pathology and Microbiology, 600 South 42nd Street, University of Nebraska Medical Center Omaha, NE 68198–4495, Fax: 402–559–4077: e-mail: [email protected]Search for more papers by this authorSteven H. Hinrichs MD
Department of Pathology and Microbiology (NDB. SHH). Eppley Institute for Research in Cancer and Allied Diseases (SHH), and Department of Surgery (JWM). Current affiliation: Sr. Luke's Hospital, Bethlehem, PA, Department of Emergency Medicine (JWM).
Search for more papers by this authorJeffrey W Morse MD, MS
Department of Pathology and Microbiology (NDB. SHH). Eppley Institute for Research in Cancer and Allied Diseases (SHH), and Department of Surgery (JWM). Current affiliation: Sr. Luke's Hospital, Bethlehem, PA, Department of Emergency Medicine (JWM).
Search for more papers by this authorABSTRACT
Objective: To determine whether direct immunologic detection of Epstein-Barr virus (EBV) early antigen diffuse component (EA-D) from nasopharyngeal swabs is a feasible approach to the development of a rapid diagnostic test for infectious mononucleosis (IM).
Methods: Nasopharyngeal swabs from 20 patients presenting with a presumptive diagnosis of IM (having the classic triad of symptoms-acute pharyngitis, fever, and lymphadenopathy) and 5 controls were assayed for EA-D. EBV serologic testing and a heterophil antibody titer (HAT) test also were performed. EA-D was assayed by polyacrylamide gel electrophoresis and subsequent transfer to a nylon membrane, followed by immunoblotting with a monoclonal antibody.
Results: EA-D was detected in 17 of 20 patients (85%) with presumptive diagnoses of IM and in 1 of 5 normal subjects and was highly significant in predicting IM (p < 0.01). There was no significant difference in numbers of positive and negative results using either EA-D assay or HAT test in patients with IM (p < 0.35). Pharyngeal exudate in the 17 pharyngitis patients with this variable documented was significantly correlated with positive EA-D (p< 0.01). but not with the HAT test (p < 1.00).
Conclusions: Immunologic detection of EBV-derived antigens from nasopharyngeal swabs is a potential early diagnostic tool for clinically suspected IM. Sensitivity and specificity in pediatric and adult populations, patients with other viral etiologies, and patients with streptoccocal pharyngitis should be determined in subsequent investigations.
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