eli5: how do medical labs find out which bacteria or viruses are in a sample if they do not know what to look for?

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So I do not mean a covid test where it is clear what pathogen to look for. More like:
“Hey lab, here is a sample of a patient that feels bad. Please find out what pathogen is inside of it.”

How does it work? And how does it work so fast that they usually return the results within 1 or 2 days?

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Anonymous 0 Comments

The fastest tests are: Is [specific pathogen] present? Those can be done with a PCR or rapid antigen test. These tests are highly targeted to a specific pathogen (they detect highly specific molecules of the pathogen) and can be done in hours. These tests are useful if a doctor has a good idea of what’s causing the trouble.

The slower tests are: Is there anything growing here that shouldn’t be here? Then you have to grow it in the lab and analyze it. That takes days or weeks to perform. We analyze what the bacteria eat, their Gram stain properties, what they produce/secrete, their shape, and the type of colonies the grow in, and a few other things. This test is useful if the doctor doesn’t have a good idea of what’s causing the trouble.

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