8 respiratory disease tests

There are 8 respiratory disease tests that are often mentioned in clinical practice, but there is no unified national fixed catalog. Currently, the most commonly used test in hospitals at all levels is the joint test for 8 high-risk respiratory pathogens, including Mycoplasma pneumoniae, Chlamydia pneumoniae, respiratory syncytial virus, adenovirus, influenza A virus, influenza B virus, parainfluenza virus, and Legionella pneumophila. The core function is to quickly identify the source of infection in 1-2 hours and avoid errors in empirical medication. It is one of the most frequently opened testing items in respiratory clinics in winter and spring.

When I was on duty in the respiratory clinic last year, I encountered too many patients who took detours. What impressed me the most was a 5-year-old boy who had been suffering from a fever for three days when his mother brought him here. A blood routine test in the community only showed a viral infection. The antiviral oral liquid and antipyretic medicine he was prescribed couldn’t be suppressed at all, and he coughed so much that he couldn’t sleep all night. The child's face was burning red when he arrived, so I directly prescribed 8 joint tests. The results came out an hour after taking the nasopharyngeal swab, which showed that it was Mycoplasma pneumoniae combined with respiratory syncytial virus infection. I adjusted the azithromycin + aerosol regimen. Three days later, the mother came for a follow-up visit and said that the child's fever had completely subsided and his cough had been reduced by most.

There are actually two different tendencies in the current clinical use of these 8 items, and there is no absolute right or wrong. One group of doctors prefers to give priority to prescribing 8 items to patients with fever and cough symptoms, especially during the winter and spring epidemic seasons. After all, quick results can enable rapid and targeted medication, which can minimize the abuse of antibiotics and prevent patients from becoming seriously ill. The other group feels that it is not necessary. Get started right away. After all, the price of a set of 8 tests ranges from 200 to 300 yuan. You can first do a blood routine + CRP for dozens of yuan to distinguish whether it is a bacterial or viral infection, and then order a single test or a joint test accordingly, which can help patients with common colds save a lot of money. Both ideas are actually considered from the patient's perspective, and are nothing more than differences in priorities.

Don’t think that the pathogens in these 8 items are far away from you. Many of them are types that are frequently infected in daily life. Needless to say, there is a wave of influenza A and B every winter and spring. When infected, the whole body aches and high fever persists. Oseltamivir is most effective if used within 48 hours. If the diagnosis is delayed for three or four days, the efficacy of the drug will be at least half. Mycoplasma pneumoniae, which has been very present in the past two years, is also among them, especially in children and adults with poor immunity. Many people have coughed for more than half a month, and there is no obvious abnormality in chest X-rays. When checked, they are positive for mycoplasma. Only symptomatic treatment with azithromycin or doxycycline can cure it. If it is treated as a common cold, it can easily lead to pneumonia. There is also Legionella pneumophila that many people have never heard of. It is basically contracted after blowing on an uncleaned central air conditioner, or after going to a public hot spring or bathhouse. In addition to fever and cough, it is also accompanied by diarrhea and muscle aches. It is especially easy to be confused with ordinary influenza. Only targeted medication can quickly improve the condition. An interesting point is that a young man blew the central air conditioner that the company had not cleaned for a week. When the temperature reached 39 degrees, he took cold medicine for three days to no avail. It was found to be a Legionella infection. The first thing he did when he was discharged was to send a message to the administration asking him to clean the air conditioner in the whole building.

Many people ask whether fasting is required to do this test? No need at all. You can do it at any time. There are two sampling methods, nasopharyngeal swab and venous blood. The nasopharyngeal swab produces results faster and can be obtained in 1-2 hours. It feels similar to taking the new coronavirus antigen test. Just poke your nose. If you are afraid of pain, you can also choose to draw blood, and the results can be obtained on the same day.

Of course, there is no need to mythologize this test. A full negative test does not mean that you are not sick. The current 8 routine items do not include pathogens such as COVID-19, rhinovirus, and human metapneumovirus. If all 8 items are negative but the symptoms are still severe, such as persistent high fever, chest tightness, shortness of breath, and coughing up yellow sputum, further more comprehensive pathogen sequencing or chest X-ray CT must be performed to find other causes.

As for whether ordinary people should get tested as soon as they have symptoms, there is really no standard answer. If you are in good physical condition and only have a low fever, a slight cough, and no other discomfort, you can observe yourself at home for two days, drink more water and take some antipyretics, and there is no need to go to the hospital; but if you have elderly children at home, or you have asthma or COPD For this kind of basic disease, if the fever reaches 38.5 degrees for more than 2 days and has not gone away, and you may even feel chest tightness and breathlessness, don't force yourself to do it. It is better to get one than anything else. Rather than taking random medicines and taking the wrong medicine and delaying the condition, spending hundreds of dollars to buy one is still cost-effective in many cases.