title: Clinical outcomes in outpatient respiratory syncytial virus infection in immunocompromised children.
abstract: BACKGROUND
  Immunocompromised patients are at high risk for morbidity and mortality due to respiratory syncytial virus (RSV) infection. Increasingly, pediatric patients with malignancy or undergoing transplantation are managed primarily as outpatients. Data regarding the clinical presentation and outcomes of RSV in the outpatient pediatric immunocompromised population are limited.
  
  
  METHODS
  We performed a retrospective cohort study of children with hematologic malignancy or hematopoietic or solid organ transplant with laboratory-confirmed RSV infection diagnosed as outpatients at an academic medical center between 2008 and 2013.
  
  
  RESULTS
  Of 54 patients with RSV detected while outpatients, 15 (28%) were hospitalized, 7 (13%) received ribavirin, and one (2%) received intravenous immunoglobulin. One (2%) patient was critically ill, but there were no deaths due to RSV infection. Fever (P < 0·01) was associated with increased risk of hospitalization.
  
  
  CONCLUSIONS
  Most immunocompromised children with RSV detected while outpatients did not require hospitalization or receive antiviral treatment. Potential studies of RSV therapies should consider inclusion of patients in an ambulatory setting.
authors: Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA.
authors: Helen Y
authors: http://orcid.org/0000-0001-8502-9600
authors: HY
authors: Chu
authors: Division of Infectious Diseases, Seattle Children's Hospital, Seattle, WA, USA.
authors: Jennifer
authors: J
authors: Chin
authors: Pediatric Hematology/Oncology, Seattle Children's Hospital, Seattle, WA, USA.
authors: Jessica
authors: J
authors: Pollard
authors: Division of Infectious Diseases, Seattle Children's Hospital, Seattle, WA, USA.
authors: Danielle M
authors: DM
authors: Zerr
authors: Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA.|Division of Infectious Diseases, Seattle Children's Hospital, Seattle, WA, USA.
authors: Janet A
authors: JA
authors: Englund
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000453:epidemiology / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010045:Outpatients; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000188:drug therapy / Q000628:therapy* / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D014180:Transplantation; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D012254:Ribavirin
keywords: Hematopoietic stem cell transplant; immunocompromised; outpatient; pediatric; respiratory syncytial virus