title: Influenza infection in neutropenic adults.
abstract: While lymphopenia is a well-defined risk factor for severe influenza, the effect of neutropenia is unknown. This was a retrospective single centre study of adult patients with documented neutropenia and influenza between 2005 and 2013. Forty patients were included with a median follow-up of 2 years (IQR 0.8-4.0). Median ANC at influenza diagnosis was 0.3 × 109/L (IQR 0.1-0.4 × 109/L). Outcomes included hospitalization (N = 28, 70%), pneumonia (N = 9, 23%), ICU admission (N = 9, 23%) and mechanical ventilation (N = 7, 18%). Three deaths (7.5%) were attributed to influenza, all of whom had lower respiratory tract infection (LRTI). Patients with LRTI (N = 18, 45%) also had a higher 30-day mortality (37 versus 0%) and 90-day mortality (42 versus 0%) than those with upper respiratory tract infection. In summary, neutropenic patients have high rates of influenza complications. Our study highlights the need for early diagnosis and aggressive management of influenza in this population.
authors.affiliation: a Department of Internal Medicine , Mayo Clinic , Rochester MN , USA.
authors.forename: Urshila
authors.initials: U
authors.lastname: Durani
authors.affiliation: b Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester MN , USA.
authors.forename: Maria V
authors.initials: MV
authors.lastname: Dioverti Prono
authors.affiliation: b Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester MN , USA.
authors.forename: Pritish K
authors.initials: PK
authors.lastname: Tosh
authors.affiliation: c Division of Hematology, Department of Internal Medicine , Mayo Clinic , Rochester MN , USA.
authors.forename: Mrinal
authors.initials: M
authors.lastname: Patnaik
authors.affiliation: d Hospital Pharmacy Services , Mayo Clinic , Rochester , MN , USA.
authors.forename: Jason N
authors.initials: JN
authors.lastname: Barreto
authors.affiliation: b Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester MN , USA.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Tande
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
keywords: Respiratory tract infection; immunocompromised host; influenza virus; neutropenia