Diagnosis

Traditionally, diagnosis has been through the use of viral cultures or serologic tests, which do not yield results for several days. These tests are not useful in individual patients except to confirm diagnosis after recovery from acute illness, but they do provide useful epidemiologic data. Some studies have shown that a clinical diagnosis of flu during a known outbreak has an accuracy of approximately 85 percent,23 but bacteremia should also be considered in patients with rigor and myalgias. Newer rapid antigen tests are becoming available that may change the approach to flulike illnesses. These tests will enable rapid diagnosis and institution of antiviral agents, and may decrease the empiric use of antibiotics. One commercially available test requires a little more than 1 h to perform and lists a sensitivity of 50 to 70 percent, with a specificity of 93 to 100 percent.4

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