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Respiratory viruses common among children with cancer experiencing fever, neutropenia
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Recent findings published in Pediatric Infectious Disease Journal showed that respiratory viral infections were found in 46% of children with cancer who were experiencing fever and neutropenia.
“To our knowledge, this is the largest report of clinical characterization caused by different types of [respiratory viruses (RVs)] and by respiratory viral coinfection in children with [fever and neutropenia (FN)],” Juan Pablo Torres, MD, PhD, faculty of medicine at the University of Chile, and colleagues wrote. “The frequency of RVs detected was similar to that observed by some authors in immunocompetent children.”
In a previous study, Torres and colleagues determined that an RV was the most frequently detected pathogen in children with cancer experiencing FN and that an RV resulted in better outcomes than a bacterial infection. In this study, the investigators sought to determine the presentation and outcomes of different types of RV coinfections.
At three Chilean hospitals, the researchers assessed 525 children (median age, 6 years) with cancer and FN. The researchers took blood cultures, performed clinical examinations and used PCR to detect 17 types of RV. They compared each assessment by RV type.
Torres and colleagues identified 1,044 episodes of FN. Among these, 46% had at least one RV detected, and 34% had only RV without any bacterial infection detected. In RV-only episodes, 81% were single infections; 19% were coinfections. In cases with at least one RV detected, 65% had respiratory symptoms present at admission. The most common RVs were rhinovirus, respiratory syncytial virus, parainfluenza, influenza, adenovirus and human metapneumovirus. There was no difference between episodes caused by different RV types, nor any difference when comparing single infection vs. coinfection for duration of fever, length of hospitalization, need for oxygen, admission to ICU and death.
In addition, there was a favorable outcome for all episodes of RV, the researchers wrote.
“We found that RVs are frequent agents in children with cancer and an episode of FN,” Torres and colleagues wrote. “More studies are needed to define the requirement for inpatient treatment of children with cancer and FN with detection of an RV infection.” – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
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