Respiratory tract viral infections in bone marrow transplant patients.
BACKGROUND
Community respiratory viruses such as respiratory syncytial virus (RSV), adenovirus, influenza A, influenza B, and the parainfluenza group are frequent causes of respiratory disease in bone marrow transplant (BMT) patients.


METHODS
During the period from March 1993 to August 1999, 810 samples of respiratory secretions, nasopharyngeal aspirate (NPA) or bronchoalveolar lavage (BAL), from 722 patients with upper respiratory infections symptoms at the BMT unit of the Federal University in the state of Paraná, Brazil were evaluated for respiratory virus infection.


RESULTS
One hundred thirty-six (17%) samples were reactive in 62 patients. RSV was found in 30 of 62 (48%), influenza A in 14 of 62 (23%), influenza B in 9 of 62 (15%), parainfluenza group in 7 of 62 (11%), and adenovirus in 2 of 62 (3%) infected patients. The most frequent clinical manifestations were cough and fever. Pneumonia occurred in 19 of 62 (31%) cases. The mortality rate was 23 of 62 (37%), being higher among patients infected with adenovirus and influenza A.


CONCLUSIONS
Infections in BMT patients occurred during the outbreak period of these viruses in the community, highlighting the need to establish surveillance measures in units with immunocompromised patients in addition to the development of sensitive and rapid diagnostic tests for the detection of these viruses in patients with respiratory symptoms.
Raboni
Sonia M
SM
Laboratory of Virology, Hospital de Clínicas da Universidade Federal do Paraná, Brazil. virologi@saude.ufpr.br.
Nogueira
Meri B
MB
Tsuchiya
Luine R V
LR
Takahashi
Gislene A
GA
Pereira
Luciane A
LA
Pasquini
Ricardo
R
Siqueira
Marilda M
MM
D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid; D005260:Female; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification; D009981:Influenza B virus / Q000302:isolation & purification; D007251:Influenza, Human / Q000453:epidemiology; D007938:Leukemia / Q000145:classification / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications / Q000821:virology; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014777:Virus Diseases / Q000453:epidemiology*