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Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii

CPT4 code

Name of the Procedure:

Infectious Agent Antigen Detection by Immunofluorescent Technique; Pneumocystis carinii

Summary

This procedure identifies the presence of Pneumocystis carinii, a type of fungus, using a special staining method called immunofluorescence. It's a diagnostic test primarily used in patients with weakened immune systems to confirm Pneumocystis pneumonia (PCP).

Purpose

This procedure is performed to detect Pneumocystis carinii infections, which can cause severe pneumonia, particularly in individuals with compromised immune systems, such as those with HIV/AIDS or those undergoing chemotherapy. The goal is to identify the infection quickly so appropriate treatment can begin.

Indications

  • Symptoms of pneumonia such as persistent cough, fever, and difficulty breathing, especially in immunocompromised patients.
  • Patients with HIV/AIDS showing signs of respiratory distress.
  • Individuals undergoing immunosuppressive treatments who present with respiratory symptoms.

Preparation

  • No special fasting or preparation is typically required for the patient.
  • Informing the doctor about any current medications.
  • Possibly performing a bronchoalveolar lavage (BAL) to obtain a proper sample from the lungs.

Procedure Description

  1. A specimen is collected, often through a bronchoalveolar lavage or other respiratory sampling methods.
  2. The specimen is treated with specific antibodies that bind to Pneumocystis carinii antigens.
  3. These antibodies are tagged with a fluorescent dye.
  4. Under a microscope, areas where the antibodies have bound to Pneumocystis carinii will fluoresce, allowing for identification of the organism.

Duration

The microscopic analysis takes approximately 1-2 hours once the sample is prepared.

Setting

This procedure is typically performed in a hospital's pathology or microbiology laboratory.

Personnel

  • Pulmonologists or other physicians to collect the sample.
  • Laboratory technicians or pathologists to perform the immunofluorescent staining and analysis.

Risks and Complications

  • Minimal risks associated with the immunofluorescence technique itself.
  • If a bronchoalveolar lavage is required to collect the sample, there are risks associated with that procedure, including bleeding, infection, or pneumothorax.

Benefits

  • Allows for rapid and accurate identification of Pneumocystis carinii.
  • Enables timely treatment, which is crucial for patients with weakened immune systems.
  • Non-invasive analysis once the sample is obtained.

Recovery

  • No specific recovery measures are needed for the staining procedure itself.
  • If bronchoalveolar lavage is performed, patients may need observation for a few hours post-procedure.

Alternatives

  • Direct fluorescent antibody (DFA) staining.
  • Molecular methods like Polymerase Chain Reaction (PCR).
  • Standard microbiological culture methods which take longer to yield results.
  • Each alternative has different accuracy rates, timeframes, and costs.

Patient Experience

  • For the immunofluorescent staining, the patient will not experience any discomfort directly from the procedure.
  • If a sample is taken via bronchoalveolar lavage, the patient might experience mild discomfort or a cough.
  • Pain management measures, such as local anesthesia, might be used during sample collection.

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