Exacerbations of idiopathic pulmonary fibrosis treated with corticosteroids and cyclophosphamide pulses.

including a lower sensitivity and greater delay before the result is available [7, 8]. The prompt and accurate detection of a respiratory virus infection in patients with underlying lung disease is important for a number of reasons. Anti-viral medications are sometimes indicated for patients with a suspected or confirmed respiratory viral infection, particularly RSV or influenza [9]. Some respiratory viral infections are associated with increased morbidity and mortality in patients with chronic lung disease [10]. Confirmation of a respiratory viral infection may therefore prompt early institution of close monitoring and supportive measures, or commencement of preemptive antibiotic therapy to prevent clinical deterioration from an accompanying bacterial exacerbation, particularly for those patients with known chronic bacterial infection. In addition, infection control measures may require prompt diagnosis of a respiratory viral infection [3]. For example, since this study ended, a case of pandemic H1N1 influenza was positive by sputum PCR but negative by nasal swab PCR. In some cases, the identification of a respiratory virus by PCR was not confirmed from a nasal swab specimen but was confirmed from an accompanying sputum sample. As many adults with CF and other chronic lung diseases produce sputum during infective exacerbations, this may be an easily available and acceptable specimen to obtain from patients for screening for viral infection, with greater sensitivity than nasal swab samples.