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Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique

CPT4 code

Name of the Procedure:

Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique.

Summary

This procedure detects the presence of Legionella pneumophila, a bacterium that causes Legionnaires' disease, by amplifying and identifying its DNA or RNA. It uses an advanced technique to accurately diagnose the infection early.

Purpose

This procedure is used to diagnose Legionnaires' disease, a severe form of pneumonia caused by Legionella pneumophila. Early detection allows for timely treatment, reducing the risk of severe complications and improving patient outcomes.

Indications

  • Persistent cough, fever, chills, and muscle aches.
  • Pneumonia symptoms unresponsive to standard antibiotics.
  • Recent history of exposure to potential Legionella sources (e.g., contaminated water systems).
  • Immunocompromised patients or those with chronic lung disease showing respiratory symptoms.

Preparation

  • No specific fasting or medication adjustments typically required.
  • Inform your healthcare provider about any medications or supplements being taken.
  • Routine blood tests and a chest X-ray may be performed beforehand to assess overall health and lung condition.

Procedure Description

  1. Sample Collection: A respiratory sample, such as sputum, bronchoalveolar lavage fluid, or lung tissue, is collected.
  2. Nucleic Acid Extraction: DNA or RNA is extracted from the sample.
  3. Amplification: Using Polymerase Chain Reaction (PCR) or similar techniques, the nucleic acids specific to Legionella pneumophila are amplified.
  4. Detection: Amplified nucleic acids are then detected using probes designed to bind specifically to Legionella pneumophila genetic material.

Tools and Equipment:

  • Respiratory sample collection devices.
  • PCR machine and related reagents.
  • Detection probes and laboratory equipment.

Anesthesia or Sedation:

  • Not required for the procedure itself, but sedation may be used during sample collection if invasive methods are used (e.g., bronchoscopy).

Duration

The entire process, from sample collection to obtaining results, can typically take a few hours to one day.

Setting

  • Hospital laboratory or specialized diagnostic center.

Personnel

  • Respiratory therapist or pulmonologist for sample collection.
  • Laboratory technicians and molecular biologists to perform the test.

Risks and Complications

  • Minimal risks associated with sample collection, such as slight discomfort or mild bleeding.
  • Rare risk of false-positive or false-negative results, addressed by repeat testing or additional diagnostic methods.

Benefits

  • Rapid and accurate detection of Legionella pneumophila.
  • Early diagnosis leading to timely and appropriate treatment.
  • Improved patient outcomes and reduced complications from delayed diagnosis.

Recovery

  • No recovery period needed for the test itself.
  • Follow-up typically involves discussing results with a healthcare provider and starting appropriate treatments if necessary.

Alternatives

  • Urine antigen test for Legionella pneumophila.
    • Pros: Non-invasive and quick results.
    • Cons: Less specific and may only detect one type of Legionella.

Patient Experience

  • The patient might feel slight discomfort during sample collection.
  • No significant pain associated with the nucleic acid detection procedure itself.
  • Pain management is generally not required, but comfort measures are taken during sample collection if invasive methods are used.

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