Respiratory viral infections in children with leukemia.
BACKGROUND
Respiratory viruses occur frequently in the community and are a common cause of fever in children. Data on respiratory viral infections in children with cancer are limited.


METHODS
A long-term, prospective, multicenter study was carried out in Finland searching for respiratory viruses in febrile children with leukemia. For this purpose, 138 febrile episodes in 51 children with leukemia were analyzed. Twelve types of respiratory viruses were searched for by viral culture, antigen detection, and polymerase chain reaction tests.


RESULTS
Evidence of a respiratory viral infection was found in 61 of 138 febrile episodes (44%), accounting for an incidence of 0.8 (range, 0-2.4) per person year at risk during the treatment of leukemia. The most common viruses detected were rhinovirus (22%), respiratory syncytial virus (11%), human bocavirus (5%), and influenza A virus (4%). Dual viral infections were detected in 12 cases (9%). Half of the children had respiratory symptoms with cough being the most common symptom. Two children developed pneumonia. The mean duration of fever was 2.6 (SD 1.7) days in children with respiratory viral infection and 2.1 (SD 1.3) days in children without evidence of viral infection (P = 0.44).


CONCLUSIONS
Respiratory viruses are found commonly during febrile episodes in children with leukemia. The detection of viruses permits the use of available antiviral agents, may explain a poor response to antimicrobial agents, and minimizes the proportion of febrile episodes without possible etiologic agents in children with leukemia.
Koskenvuo
Minna
M
Department of Pediatrics, Turku University Hospital, Turku, Finland. minnak@stanford.edu
Möttönen
Merja
M
Rahiala
Jaana
J
Saarinen-Pihkala
Ulla M
UM
Riikonen
Pekka
P
Waris
Matti
M
Ziegler
Thedi
T
Uhari
Matti
M
Salmi
Toivo T
TT
Ruuskanen
Olli
O
D000293:Adolescent; D052660:Bocavirus / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000150:complications / Q000821:virology; D003428:Cross Infection / Q000150:complications / Q000821:virology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000302:isolation & purification; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000821:virology; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012229:Rhinovirus / Q000302:isolation & purification; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis / Q000821:virology*