QUESTION: I have a patient and I’d like to draw her for the CMV, EBV, and HHV-6, we’ve tried a bunch of stuff already, but I’d like it to be covered. Thoughts?
ANSWER: Generally, I do the following for chronic ID screening. The asterisk (*) ones are if we are limiting to ‘most likely’ positives to find (more common in my case now days unless I really feel substantiating a LOT of ID exposure is needed.)
EBV chronic and acute (4 IG profile)
* EBV Ea IgG
CMV Ig G and M
HHV-6
Parvo B-19 Ig G and M (if rheumatic)
Lyme Ig screen with Reflex to western blot
* C. pneumo Ig G A and M
* M. pneumo Ig G and M (wishing for ‘A’)
* ASO
* H. pylori Ig A
H. pylori Ig G-A-M
* Candida Ig G-A-M
all others are PRN Sx.