Format

Send to

Choose Destination
J Pediatric Infect Dis Soc. 2014 Dec;3(4):286-93. doi: 10.1093/jpids/piu100. Epub 2014 Oct 21.

Respiratory Tract Infections Due to Human Metapneumovirus in Immunocompromised Children.

Author information

1
Department of Medicine, University of Washington.
2
Division of Infectious Diseases.
3
Division of Hematology-Oncology, Seattle Children's Hospital.
4
Department of Laboratory Medicine, University of Washington, Seattle.

Abstract

BACKGROUND:

The clinical presentation and management of human metapneumovirus (hMPV) infections in immunocompromised children is not well understood.

METHODS:

We performed a retrospective evaluation of pediatric patients with laboratory-confirmed hMPV infections and underlying hematologic malignancy, solid tumors, solid organ transplant, rheumatologic disease, and/or receipt of chronic immunosuppressants. Data were analyzed using t tests and Fisher's exact tests.

RESULTS:

Overall, 55 patients (median age: 5 years; range: 5 months-19 years) with hMPV infection documented between 2006 and 2010 were identified, including 24 (44%) with hematologic malignancy, 9 (16%) undergoing hematopoietic stem cell transplant, 9 (16%) with solid tumors, and 8 (15%) with solid organ transplants. Three (5%) presented with fever alone, 35 (64%) presented with upper respiratory tract infections, and 16 (29%) presented with lower respiratory tract infections (LRTI). Twelve (23%) patients required intensive care unit admission and/or supplemental oxygen ≥28% FiO2. Those with severe disease were more likely to be neutropenic (P = .02), but otherwise did not differ by age (P = .27), hematopoietic stem cell transplant recipient status (P = .19), or presence of lymphopenia (P = .09). Nine (16%) patients received treatment with ribavirin, intravenous immunoglobulin, or both. Three children (5%) died of hMPV pneumonia.

CONCLUSIONS:

Immunocompromised pediatric patients with hMPV infection have high rates of LRTI and mortality. The benefits of treatment with ribavirin and intravenous immunoglobulin in this patient population require further evaluation.

KEYWORDS:

human metapneumovirus; immunocompromised; pediatric; transplant; treatment

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center