940. Respiratory Infection due to Metapneumovirus in Adults: A Disease of Immunocompromised Patients
Session: Poster Abstract Session: Biomarkers and Risk Factors for Viral Infections
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Human metapneumovirus (hMPV) is a paramyxovirus associated with upper and lower respiratory tract infections primarily in the pediatric population. While influenza and respiratory syncytial virus (RSV) are commonly recognized respiratory viral pathogens in adults, particularly in the immunocompromised population, there is limited data on the incidence or severity of hMPV infections in immunocompromised adults. Methods: A retrospective review of all respiratory viral RT-PCR tests (using Luminex xTAG RVP) performed at the Rush Microbiology Laboratory from 1 January 2008 to 1 October 2009 was performed.  All adult patients (>18 years) with hMPV infection were included.  Chart review was performed and demographic data, clinical symptoms and signs, co-morbidities, and outcomes were recorded. Results: 26 adult patients were identified with hMPV infection.  The median age of patients was 63.5 years and 50% were males.  23 (89%) patients were hospitalized. The majority of patients had underlying medical conditions:  18 (69%) patients were immunosuppressed and 22 (85%) had a chronic medical illness.  The most common underlying medical conditions were: active malignancy (9), chronic lung disease (7), transplantation (3 kidney transplants and 3 hematopoietic stem cell transplants), corticosteroid use (5), and human immunodeficiency virus (2). The most common clinical presentations included: influenza-like illnesses (8), community associated pneumonia (11) and severe pneumonia requiring intensive care unit admission (4). More specifically, 23 (88%) patients reported cough, 8 (31%) had fever (T ≥ 100.4° F), and 7 (27%) were hypoxic (pulse-oximetry < 94%).  19 patients had chest imaging performed and 11 (58%) had a lung infiltrate. Co-infection with bacteria was found in only 1 patient. There were no deaths attributable to hMPV. Conclusion: hMPV is a clinically significant cause of respiratory infections, particularly among immunocompromised adult patients and patients with an underlying chronic illness, and may cause severe respiratory illness.  The diagnosis of hMPV should be considered in any immunocompromised patient with respiratory symptoms in which no other bacterial or viral respiratory pathogen is identified.

Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Aimee Hodowanec, MD and Kamaljit Singh, MD, Section of Infectious Disease, Rush Univ. Med. Ctr., Chicago, IL


A. Hodowanec, None

K. Singh, None

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