title: One-Year Prospective Study of Community Acquired Influenza and Parainfluenza Viral Infections in Hospitalized Egyptian Children with Malignancy: Single Center Experience.
abstract: BACKGROUND
  Respiratory viruses are widespread in the community and easily transmitted to immunocompromised patients.
  
  
  OBJECTIVE
  Assess the prevalence of community-acquired respiratory viral infections among children with cancer presenting with clinical picture suggestive of lower respiratory tract infections (LRTIs), and evaluate its risk factors and prognosis.
  
  
  METHODS
  Over a year, 90 hospitalized children with malignancy and LRTIs recruited, subjected to clinical assessment, investigated through hematology panel, blood culture, chest x-ray, CT chest and PCR for influenza A and B, parainfluenza (PIV) types 1 and 3 viruses, and respiratory syncytial virus (RSV), and prospectively followed up for the clinical outcome.
  
  
  RESULTS
  Viral pathogens were identified in 34 patients (37.7%), with a seasonal peak from April to May. The most frequently detected virus was influenza virus [type A (16 cases; 47%), type B (4 cases; 12%)] followed by parainfluenza virus [PIV1 (9 cases; 26%), PIV3 (3 cases; 15%)], and none had RSV. Bacteria were identified in 26 patients, fungi in four, mixed infections [bacterial/viral and bacterial/fungal] in 13, and 36 cases had unidentified etiology. The majority of patients with influenza and parainfluenza infections had hematological malignancy, presented with fever, and had mild self-limited respiratory illness. Five patients with mixed viral and bacterial infection had severe symptoms necessitating ICU admission. Six patients died from infection-related sequelae; two had mixed PIV and Staphylococcal infections.
  
  
  CONCLUSIONS
  Community acquired influenza and parainfluenza infections are common in pediatrics patients with malignancy, either as isolated or mixed viral/bacterial infections. Clinical suspicion is essential as hematological and radiological manifestations are nonspecific. Rapid diagnosis and management are mandatory to improve patients' outcome.
authors: Paediatric Department, Faculty of Medicine, Ain Shams University , Cairo , Egypt.
authors: Azza A G
authors: AA
authors: Tantawy
authors: Moustafa M A
authors: MM
authors: Barakat
authors: Amira A M
authors: AA
authors: Adly
authors: Fatma S E
authors: FS
authors: Ebeid
authors: Manal F El
authors: MF
authors: Shamaa
authors: Mohamed
authors: M
authors: Yassin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D004534:Egypt / Q000453:epidemiology; D005260:Female; D019337:Hematologic Neoplasms / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D018184:Paramyxoviridae Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011446:Prospective Studies
keywords: childhood cancer; influenza; parainfluenza; respiratory infections