Tissue Tests for Dengue Virus
Nucleic Acid Amplification Test (NAAT) for Fixed Tissue Specimens
Tissue tests for dengue virus may be performed on biopsy or autopsy specimens.
What is the test?
A NAAT, like real-time reverse transcription polymerase chain reaction (rRT-PCR) or in situ hybridization, detects dengue virus RNA.
How should it be used and at what time during infection?
- Fixed tissue samples can be tested using NAAT.
- NAATs are less sensitive after day 7 of illness.
Specimen types
Fixed liver, kidney, spleen, and lung tissue are optimal for dengue virus testing. Please note that in the setting of unexplained, potentially infectious deaths with multisystem involvement, submission of specimens from all major organs is recommended, specifically those with any significant pathologic findings.
Interpretation of results
- A positive result confirms the presence of dengue virus in tissue. However, other causes of death should be considered. A negative result does not preclude infection.
- Diagnosis should be interpreted within the context of histopathologic findings, clinical and epidemiologic history, and other laboratory studies.
Availability
This testing is only available in reference laboratories such as those from the CDC as part of forensic examination to rule out dengue as a possible cause of death.
Immunohistochemical (IHC) Analysis for Fixed Tissue Specimens
What is the test?
- Pathologists use immunohistochemical (IHC) analysis to identify dengue virus in tissues.
- The technique uses specific antibodies, which localize to the antigens of the etiologic agent of interest.
- Because the technique uses formalin-fixed tissues, specimen transport is simplified, allowing retrospective studies and minimizing laboratory worker exposure to infectious agents.
- CDC’s Infectious Diseases Pathology Branch offers additional information on diagnostic techniques.
How should it be used and at what time during infection?
Testing of fixed tissue is only available for forensic purposes.
Specimen types
Fixed liver, kidney, spleen, and lung tissue are optimal for dengue virus testing. Please note that in the setting of unexplained, potentially infectious deaths with multisystem involvement, submission of all major organs is recommended, specifically those with any significant pathologic findings.
Interpretation of results
- A positive result confirms the presence of dengue virus in tissue. However, other causes of death should be taken into consideration. A negative result does not preclude infection.
- Diagnosis should be interpreted within the context of histopathologic findings, clinical and epidemiologic history, and other laboratory studies.
Availability
This testing is only available in reference laboratories such as those from the CDC as part of forensic examination to rule out dengue as a possible cause of death.