title: Impact of parainfluenza virus infection in pediatric cancer patients.
abstract: BACKGROUND
  Respiratory virus (RV) infection can cause significant morbidity and mortality in pediatric cancer patients. Parainfluenza virus (PIV) is a common pathogen in childhood among the respiratory viruses. The objective of this study is to evaluate the impact of parainfluenza virus infection in pediatric cancer patients.
  
  
  METHODS
  A retrospective review of medical records of 1,554 children diagnosed with cancer from January 2000 through July 2008 was analyzed at Samsung Medical Center.
  
  
  RESULTS
  A total of 6.4% (137/1,554) had respiratory virus infection and 54% (74/137) of patients with RV infection had PIV infection. PIV type 3 was the predominant subtype. Among patients with PIV infection, 59 children (79.7%) had upper respiratory tract infection (URI) whereas 15 children (20.3%) had lower respiratory tract infection (LRI) at initial presentation. Among patients with URI, 12 (20.3%) progressed to pneumonia with the median interval of 4 days from URI to LRI. Mortality associated with PIV infection was 18.5% (5/27) in patients with LRI. Among patients with PIV infection, 80% (59/74) had nosocomial infection, which shows the difficulty and importance of infection control at pediatric cancer ward.
  
  
  CONCLUSIONS
  PIV infection was most commonly diagnosed among pediatric cancer patients with RV infection and PIV infection led to significant pulmonary complications and direct mortality in immunocompromised children. Since there are no effective antiviral agents for PIV infection, precautionary infection control and early diagnosis are the only methods available to prevent the infection spread.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Se Hyun
authors.initials: SH
authors.lastname: Maeng
authors.forename: Hye Soo
authors.initials: HS
authors.lastname: Yoo
authors.forename: Soo-Han
authors.initials: SH
authors.lastname: Choi
authors.forename: Keon Hee
authors.initials: KH
authors.lastname: Yoo
authors.forename: Yae-Jean
authors.initials: YJ
authors.lastname: Kim
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Sung
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
authors.forename: Hong Hoe
authors.initials: HH
authors.lastname: Koo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000150:complications / Q000175:diagnosis; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000276:immunology / Q000821:virology; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000175:diagnosis; D010996:Pleural Effusion / Q000209:etiology; D011030:Pneumothorax / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012141:Respiratory Tract Infections / Q000150:complications* / Q000175:diagnosis