An outbreak of respiratory syncytial virus infection in hematopoietic stem cell transplantation outpatients: good outcome without specific antiviral treatment.
BACKGROUND
Respiratory syncytial virus (RSV) is a common cause of seasonal respiratory viral infection in hematopoietic stem cell transplantations (HSCT) patients. The efficacy of treatment, however, remains controversial. We describe an outbreak of 31 cases of RSV that occurred in an HSCT outpatient care unit in the fall season from March through May 2010, with a good outcome without any specific antiviral treatment.


METHODS
During these 3 months, 222 nasal wash samples were tested and, of these, 31 outpatients were positive for RSV. In 2009, 99 samples had been tested and only 10 outpatients were positive for RSV in the same period.


RESULTS
Seven (22.5%) patients had severe neutropenia (<500 cells/μL); severe lymphopenia (<200 cells/μL) was present in 13 (41.9%) patients, and 14 (45%) had received intravenous broad-spectrum antibiotics. Hospitalization was necessary only for 8 patients (25.8%); 20 had lower respiratory tract infection (64.5%). Only 1 patient died as a result of proven invasive aspergillosis.


CONCLUSIONS
This report suggests that HSCT outpatients with no risk factors may not always require specific treatment for RSV.
Departamento de Molestias Infecciosas, Hospital das Clínicas-Faculdade de Medicina Universidade de São Paulo, São Paulo, Brasil.
E T
ET
Mendes
J
J
Ramos
D
D
Peixoto
F
F
Dulley
T
T
Alves
L S
LS
Vilas Boas
M V
MV
Batista
D P
DP
da Silva
A S
AS
Levin
M A
MA
Shikanai-Yasuda
S F
SF
Costa
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D003428:Cross Infection; D004196:Disease Outbreaks; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000821:virology; D010045:Outpatients; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy / Q000453:epidemiology*; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
D000998:Antiviral Agents