Do healthcare providers test for rhinovirus (Polymerase Chain Reaction or PCR) in patients with upper respiratory infections?

Testing for Rhinovirus in Upper Respiratory Infections

Healthcare providers do not routinely test for rhinovirus in patients with upper respiratory infections, as testing is generally not recommended for uncomplicated cases due to the self-limiting nature of the infection and lack of specific antiviral treatments.

Current Testing Practices for Respiratory Viruses

• Testing for rhinovirus is not routinely performed in standard clinical practice for uncomplicated upper respiratory infections, as rhinovirus infections are typically mild and self-limiting 1, 2
• Healthcare providers may consider testing for respiratory viruses (including rhinovirus) in specific clinical scenarios:
  • In hospitalized patients with suspected pneumonia or respiratory symptoms 3
  • In immunocompromised patients where viral infections may cause more severe disease 3
  • During outbreaks in healthcare settings to guide infection control measures 3
  • In research settings to understand viral epidemiology 4

Available Testing Methods for Rhinovirus

• Nucleic acid amplification tests (NAATs) are the primary method for detecting rhinovirus, typically using:

  • Real-time RT-PCR
  • Multiplex PCR assays that detect multiple respiratory pathogens simultaneously
  • Isothermal nucleic acid amplification 3

• Specimen types commonly used for rhinovirus testing include:

  • Nasopharyngeal swabs (most common)
  • Nasal swabs
  • Nasal aspirates
  • Nasal washes
  • Throat swabs 3

Clinical Scenarios Where Testing May Be Considered

• In critically ill patients with new fever and suspected pneumonia or upper respiratory infection symptoms, testing for viral pathogens using viral NAAT panels may be appropriate 3
• In healthcare settings during outbreaks to identify the causative pathogen and implement appropriate infection control measures 3
• In patients with exacerbations of underlying respiratory conditions such as asthma or COPD, where rhinovirus is a common trigger 2, 5
• In high-risk populations where respiratory viral infections may lead to more severe complications 3

Limitations and Considerations

• Detection of rhinovirus in multiplex assays may not prove causality, as some viruses like rhinovirus can persist for up to 30 days beyond acute infection 3
• Testing for rhinovirus generally does not change clinical management in otherwise healthy individuals with uncomplicated upper respiratory infections 2, 5
• No FDA-approved antiviral treatments are currently available specifically for rhinovirus infections, limiting the clinical utility of testing in most outpatient settings 1, 2
• The cost of testing and limited impact on clinical outcomes must be considered when deciding whether to test for rhinovirus 3

Conclusion

• Rhinovirus testing is not routinely performed in patients with uncomplicated upper respiratory infections 1, 2
• Testing may be appropriate in specific clinical scenarios such as severe illness, immunocompromised hosts, or during outbreaks 3
• When testing is performed, nucleic acid amplification tests (particularly multiplex PCR panels) are the preferred method 3