Conventional Respiratory Viruses Recovered from Immunocompromised Patients: Clinical Considerations

Abstract

Lower respiratory tract infection is the most common complication in the immunocompromised patient. From January 1991 to December 1995, 785 consecutive patients with suspected respiratory tract infections were studied. One hundred ninety-nine viruses were isolated from 182 (23%) of 785 bronchoalveolar lavage fluid specimens. Cytomegalovirus was isolated from 131 patients, herpes simplex virus was recovered from 31, and conventional respiratory viruses (CRVs) were recovered from 36. There were 9 influenza A viruses, 2 influenza B viruses, 7 parainfluenza viruses, 5 respiratory syncytial viruses, 5 adenoviruses, 6 enteroviruses, and 3 rhinoviruses. We identified 22 patients from whom a CRV was the only microorganism recovered; 13 patients developed pneumonia, 10 had acute respiratory failure, 5 required support with mechanical ventilation, and 5 (23%) died. In conclusion, CRVs are frequent causes of respiratory illnesses and are associated with high rates of morbidity and mortality among immunocompromised patients.

Respiratory Virus Infections in Children With Cancer or HIV Infection

“…The severity of respiratory viral disease in our patients with cancer is in concordance with other studies that have documented a high frequency of pneumonia and death associated with respiratory viral infections in persons with cancer and hematologic malignancies. 1,3,13,24 In our study, 2 (7%) oncology patients with RSV infection died. Both children had severe neutropenia (60 and 100 neutrophils/mm 3 ) when they acquired the viral infection.…”

“…In healthy children these viruses usually cause upper respiratory tract infections, with a self-limited and benign course. However, they can lead to severe disease, with significant morbidity and mortality, in immunocompromised patients, [1][2][3][4] especially in the setting of myelosuppression 5 and/or hematopoietic stem cell transplant (HSCT). [5][6][7][8] Several studies in adults have shown that common respiratory virus infections progress to lower respiratory tract disease and pneumonia in up to 30% to 50% of immunosuppressed HSCT recipients.…”

Comparison of a Multiplex Reverse Transcription-PCR-Enzyme Hybridization Assay with Conventional Viral Culture and Immunofluorescence Techniques for the Detection of Seven Viral Respiratory Pathogens

“…Although the viruses tested for in the present study have previously been reported to be significant pathogens, especially in immunocompromised bone marrow and lung transplant recipients (24,29), the patient population in our study was not specifically targeted to assess the incidence of these infections through a winter period. Future work would aim at a more targeted population.…”

Detection of Rhinoviruses by Tissue Culture and Two Independent Amplification Techniques, Nucleic Acid Sequence-Based Amplification and Reverse Transcription-PCR, in Children with Acute Respiratory Infections during a Winter Season

“…However, they may also be associated with more-severe lower respiratory tract infections in children, in the elderly (23,24,30,33), and in immunocompromised patients (14,39,48,49). RVs have been isolated from cases of cystic fibrosis (44), otitis media (3), sinusitis (37), and exacerbations of chronic bronchitis and asthma (12,21,22,34).…”