Comparative sensitivity of three methods for the diagnosis of cytomegalovirus lung infection

Conventional cell culture (CCC), an immunofluorescent assay for the rapid detection of CMV-induced early antigens (DEAFF) in infected fibroblasts and an immunofluorescent assay for the detection of CMV-infected cells obtained directly from clinical material were compared prospectively for their ability to detect CMV in bronchoalveolar lavage (BAL) material. CMV was detected by at least one method in 47 of 139 BALs (33.8%). The mean sensitivities of each of the three assays were 93% for DEAFF, 46% for CCC and 22% for the direct method. The mean time to diagnosis was 24 h, 15 days and 4 h for each of the methods, respectively. The use of monoclonal antibodies in the DEAFF test on BAL specimens provided a simple and rapid method for the diagnosis of CMV lung infection and was shown to be more reliable than conventional culture methods in achieving a diagnosis from BAL specimens.