title: Viral infections in patients with an acute exacerbation of idiopathic interstitial pneumonia.
abstract: BACKGROUND
  Patients with slowly progressive idiopathic interstitial pneumonia, including idiopathic pulmonary fibrosis, often deteriorate, thus suggesting that the clinical course may be unpredictable. Such episodes are termed acute exacerbation of idiopathic interstitial pneumonia. The etiology of an acute exacerbation of idiopathic interstitial pneumonia is unknown. In this study, we tested the hypothesis that an acute exacerbation of idiopathic interstitial pneumonia is induced by respiratory viral infections.
  
  
  METHODS
  Bronchoalveolar lavage fluid obtained from patients with an acute exacerbation of idiopathic interstitial pneumonia was tested for viral nucleic acid using polymerase chain reaction.
  
  
  RESULTS
  Only 1 of the 14 patients with an acute exacerbation of idiopathic interstitial pneumonia exhibited evidence of respiratory syncytial virus B, and 2 patients exhibited evidence of cytomegalovirus. Seven patients fulfilled the diagnostic criteria of idiopathic pulmonary fibrosis.
  
  
  CONCLUSIONS
  Most cases with an acute exacerbation of idiopathic interstitial pneumonia are not caused by a viral infection.
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto City, Nagano Prefecture 390-0316, Japan. Electronic address: atsuhito@shinshu-u.ac.jp.
authors.forename: Atsuhito
authors.initials: A
authors.lastname: Ushiki
authors.affiliation: Department of Infectious Disease, Suzaka Hospital, 1332 Suzaka City, Nagano Prefecture 382-0091, Japan. Electronic address: yamazaki-yoshitaka@pref-nagano-hosp.jp.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamazaki
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto City, Nagano Prefecture 390-0316, Japan. Electronic address: jcoc511_mc@yahoo.co.jp.
authors.forename: Mineyuki
authors.initials: M
authors.lastname: Hama
authors.affiliation: Endoscopic Examination Center, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto City, Nagano Prefecture 390-0316, Japan. Electronic address: yasumasa@shinshu-u.ac.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuo
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto City, Nagano Prefecture 390-0316, Japan. Electronic address: masayuki@shinshu-u.ac.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hanaoka
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto City, Nagano Prefecture 390-0316, Japan. Electronic address: keishik@shinshu-u.ac.jp.
authors.forename: Keishi
authors.initials: K
authors.lastname: Kubo
mesh_terms: D000210:Acute-Phase Reaction; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D018450:Disease Progression; D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D020551:Pulse Therapy, Drug; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology
chemical_list: D008775:Methylprednisolone
keywords: Acute exacerbation; BAL; BALF; CMV; DNA; IIP; IL; IPF; Idiopathic interstitial pneumonia; Idiopathic pulmonary fibrosis; PCR; RNA; RT; Sd; Viral infection; bronchoalveolar lavage; bronchoalveolar lavage fluid; cytomegalovirus; deoxyribonucleic acid; idiopathic interstitial pneumonia; interleukin; interstitial pulmonary fibrosis; polymerase chain reaction; reverse transcriptase; ribonucleic acid; standard deviation