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Human Metapneumovirus Workup

  • Author: Ashley Maranich, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
 
Updated: Apr 21, 2014
 

Laboratory Studies

Human metapneumovirus (hMPV) is difficult to grow in cell culture, largely explaining the delay in recognizing this pathogen, which has been causing disease for 50 years. Isolation is possible in a limited number of cell lines and requires trypsin supplementation. This is not a clinically useful mode of diagnosis given these technical limitations and the prolonged time to effectively culture hMPV.

  • Serological diagnosis is possible using enzyme-linked immunoassays (ELISA). However, seropositivity is nearly universal after early childhood, making definitive serological diagnosis reliant on seroconversion or a 4-fold titer increase on serial samples.
  • Immunofluorescence testing has been developed for hMPV and is available through commercial laboratories but is not yet widely used in clinical settings.
  • The most sensitive means of hMPV infection diagnosis is by PCR of respiratory secretions, which is currently the most commonly used method. In research settings, this technique is also being used to quantify viral load.

Given the prevalence of hMPV, more widespread availability of rapid diagnostic tests would be clinically useful.

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Imaging Studies

Although chest radiography is often obtained in patients with significant lower respiratory tract disease, no findings distinguish hMPV from other causes of viral pneumonia or bronchiolitis.

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Contributor Information and Disclosures
Author

Ashley Maranich, MD Pediatric Infectious Disease Staff, San Antonio Military Medical Center, Wilford Hall Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Michael Rajnik, MD Associate Professor, Department of Pediatrics, Program Director, Pediatric Infectious Disease Fellowship Program, Uniformed Services University of the Health Sciences

Michael Rajnik, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John W King, MD Professor of Medicine, Chief, Section of Infectious Diseases, Director, Viral Therapeutics Clinics for Hepatitis, Louisiana State University Health Sciences Center; Consultant in Infectious Diseases, Overton Brooks Veterans Affairs Medical Center

John W King, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Federation for Medical Research, Association of Subspecialty Professors, American Society for Microbiology, Infectious Diseases Society of America, Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Program Director of Infectious Disease Fellowship, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Michael D Nissen, MBBS, FRACP, FRCPA, Theodorus P Sloots, PhD, and David Siebert, MD, to the development and writing of this article.

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Phylogenetic tree showing sequence analysis of human metapneumovirus (hMPV).
 
 
 
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