Two Cases of Primary Human Parainfluenza Virus 1 Pneumonia in Which Bronchoalveolar Lavage Fluid Yielded Human Parainfluenza Virus 1

Ishiguro, Takashi; Kobayashi, Yasuhito; Takano, Kenji; Ozawa, Ryota; Shimizu, Yoshihiko; Takayanagi, Noboru

doi:10.2169/internalmedicine.3435-19

Cited by 5 publications

(7 citation statements)

References 18 publications

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“…To the best of our knowledge, these patients are the rst reported cases of eosinophilic pneumonia caused by parain uenza virus. Basic studies have shown that eosinophils in guinea pig BAL uid are also increased by infection with parain uenza virus [18], and in two case reports of parain uenza virus pneumonia, the eosinophil fraction in BAL uid was slightly elevated [19]. Thus, reports of eosinophilic airway in ammation due to parain uenza infection are not uncommon and are consistent with the causes of eosinophilic pneumonia, as in the cases in this study.…”

Section: Discussionsupporting

confidence: 88%

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Nabeya

Setoguchi

Ueno

et al. 2023

Preprint

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Background:Eosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory viral infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital. Methods: Among the BAL procedures performed at our hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on the eosinophil fraction of BAL was analyzed using statistical analysis. A case study of respiratory virus detection in which the eosinophil fraction of BAL was elevated was also conducted. Results: A total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a trend toward a higher eosinophil fraction in BAL fluid than the PCR-negative group (p=0.030), and more cases had a BAL eosinophil fraction >3% (p=0.017). Multivariate analysis showed that PCR-positive cases were associated with BAL eosinophil fractions >1% and >3%. There were nine PCR-positive cases with a BAL eosinophil fraction >1%, of which two cases with parainfluenza virus infection had a significantly elevated BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia. Conclusions: A trend toward an elevated eosinophil fraction in BAL fluid was observed in cases of viral infection of the lower respiratory tract. The degree of eosinophilic fraction elevation due to respiratory viral infection was mild overall, whereas some cases showed prominent elevation and were diagnosed with eosinophilic pneumonia. Respiratory viral infection is not a rare cause of elevated BAL eosinophilic fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.

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Section: Discussionsupporting

confidence: 88%

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Nabeya

Setoguchi

Ueno

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Although there have been reports of cases of eosinophilic pneumonia with a marked elevation of BAL eosinophil fraction in influenza virus infection and COVID-19 [24][25][26], there are no reports of eosinophilic pneumonia caused by parainfluenza virus. There has been a case report of parainfluenza virus pneumonia; however, the increase of BAL eosinophils was mild and not eosinophilic pneumonia [27]. It is likely that there are many more cases of eosinophilic pneumonia caused by respiratory viral infections in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

et al. 2023

View full text Add to dashboard Cite

Background Eosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory virus infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital. Methods Among the BAL procedures performed at the University of the Ryukyu Hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on BAL eosinophil fraction was analyzed using statistical analysis. A case study was conducted on respiratory virus detection, which showed an elevated BAL eosinophil fraction. Results A total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a higher BAL eosinophil fraction than the PCR-negative group (p = 0.030), and more cases had a BAL eosinophil fraction > 3% (p = 0.017). Multivariate analysis revealed that being PCR-positive was significantly associated with BAL eosinophil fraction > 1% and > 3%. There were nine PCR-positive cases with a BAL eosinophil fraction > 1%, of which two cases with parainfluenza virus infection had a marked elevation of BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia. Conclusions Cases of viral infection of the lower respiratory tract showed an elevated BAL eosinophil fraction. The increase in eosinophil fraction due to respiratory virus infection was generally mild, whereas some cases showed marked elevation and were diagnosed with eosinophilic pneumonia. Respiratory virus infection is not a rare cause of elevated BAL eosinophil fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.

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“…28 Transbronchial lung biopsy from two immunocompetent patients showed an infiltration of neutrophils, macrophages, lymphocytes, and fibrin exudation. 5 These observations suggest that the disease severity of hPIVs-associated pneumonia might relate to the dysregulation of host-virus immune response. PB parameters, which are easily accessible and reflect the immune system status, are valuable for disease severity evaluation and the subsequent clinical management of the patients.…”

Section: Pcamentioning

confidence: 99%

“…It was generally thought that hPIVs‐induced pneumonia could be attributed to high levels of viral replication, resulting in a specific attack against target cells 4 . However, histopathology of pneumonia caused by hPIVs, which had been studied in more detail, was characterized by obstruction of the small airways by inflammatory cell debris, edema, and external compression of the bronchioles from hyperplastic lymphoid follicles 5 . Thus, disease severity is not only due to viral infection but it is strongly influenced by the characteristics of the host immune response to hPIVs infection.…”

Section: Introductionmentioning

confidence: 99%

Peripheral blood parameters for predicting PICU admission and mechanical ventilation in pediatric inpatients with human parainfluenza virus‐induced pneumonia

Chu

Liu

et al. 2023

Journal of Medical Virology

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Human parainfluenza viruses (hPIVs)-induced pneumonia is an important cause of pediatric hospitalization, and some develop severe pneumonias requiring pediatric intensive care unit (PICU) admission and mechanical ventilation (MV). The aim of this study is to investigate the value of peripheral blood (PB) parameters available on admission in predicting the need for PICU admission and MV due to pneumonia caused by hPIVs. A total of 331 cases including 277 (83.69%) on the general ward (GW) and 54 (16.31%) on the PICU were enrolled between January 2016 and June 2021. Of 54 patients admitted to the PICU, 24 patients (7.25%) received MV, whereas 30 (9.06%) did not. For both the PICU and GW groups, infants accounted for the highest proportion while school children had the lowest. Compared with the GW group, the PICU group had significantly higher rates of premature birth, fatigue, sore throat, headache, chest pain, tachypnea, dyspnea, and underlying diseases including congenital tracheal stenosis, congenital heart disease (CHD), metabolic disorder, and neurological disorder (ND), but significant lower proportion of exclusive breastfeeding and Z-scores for weight-for-height, weight-for-age, heightfor-age, and body-mass-index (BMI)-for-age (BMIZ). Higher levels of some leukocyte differential counts (LDC)-related parameters including counts of neutrophil (N), ratios of neutrophil-to-lymphocyte ratio (NLR), derived neutrophils/(leukocytes minus neutrophils) ratio (dNLR), and platelet-to-lymphocyte ratio (PLR), lower levels of some other LDC-related parameters including lymphocyte (L) and monocyte (M) counts, ratios of lymphocyte-to-monocyte ratio (LMR), lymphocyte-to-C-reactive protein ratio, and prognostic nutritional index (PNI), and lower levels of PB protein (PBP)-related parameters including red blood cell (RBC), hemoglobin, total protein (TP), and serum albumin were observed in the PB of patients in the PICU compared with those in the GW. Notably, higher PLR level and two comorbidities including CHD and ND were identified as independent risk factors for PICU admission, while lower PNI level as well as smaller numbers of RBC and L as good predictors. Low levels of TP might be a useful predictor of the need for MV. Overall, the relative contributions of LDC-and PBP-related factors for accurate identification of patients

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Two Cases of Primary Human Parainfluenza Virus 1 Pneumonia in Which Bronchoalveolar Lavage Fluid Yielded Human Parainfluenza Virus 1

Cited by 5 publications

References 18 publications

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Peripheral blood parameters for predicting PICU admission and mechanical ventilation in pediatric inpatients with human parainfluenza virus‐induced pneumonia

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