Täger F Marlis, Zolezzi R Paola, Folatre B Isabel, Navarrete C Maritza, Rojas P Juana
Instituto de Pediatría, Facultad de Medicina, Universidad Austral de Chile, Chile.
Rev Chilena Infectol. 2006 Jun;23(2):118-23. doi: 10.4067/s0716-10182006000200003. Epub 2006 May 16.
Respiratory viruses are the most common infections in healthy children. The impact of these infections in cancer patients has been only recently recognized in Chile.
To establish the frequency and epidemiological-clinical profile of respiratory virus infections in children younger than 15 years of age with acute lymphoblastic leukemia requiring hospitalization due to a febrile neutropenic episode.
All children < 15 years of age requiring hospitalization in the Regional Hospital of Valdivia, Chile, with cancer, fever and neutropenia between November 1 2002 and October 31 2004 were studied. Nasopharyngeal aspirate were obtained and tested by direct immunofluorescent assays for influenza A-B virus, parainfluenza virus type 1, 2, 3, respiratory syncytial virus (RSV) and adenovirus.
Respiratory viruses were detected in 25% of 44 febrile neutropenia episodes occurring in 25 patients. Viruses detected were, influenza (3/11), parainfluenza (3/11) RSV (2/11), adenovirus (1/11), parainfluenza + RSV (1/11), and parainfluenza + adenovirus (1/11). Four (36%) of cases were nosocomial. Respiratory symptoms were present in 9 children, seven of whom had inferior respiratory tract symptoms. One patient died of persistent RSV infection, agranulocytosis and extensive bilateral pneumonia.
Respiratory viruses were detected in 25% of febrile neutropenic episodes in children with ALL. This high detection rate together with the frequent involvement of the lower respiratory tract and the possibility of death strongly favors the inclusion of respiratory virus diagnostic tests in the evaluation of these children during autumn and winter season.
呼吸道病毒是健康儿童中最常见的感染源。这些感染对癌症患者的影响直到最近才在智利得到认识。
确定因发热性中性粒细胞减少症发作而需要住院治疗的15岁以下急性淋巴细胞白血病儿童呼吸道病毒感染的频率和流行病学 - 临床特征。
对2002年11月1日至2004年10月31日期间在智利瓦尔迪维亚地区医院因癌症、发热和中性粒细胞减少症而需要住院治疗的所有15岁以下儿童进行研究。采集鼻咽抽吸物，通过直接免疫荧光测定法检测甲型 - 乙型流感病毒、1、2、3型副流感病毒、呼吸道合胞病毒（RSV）和腺病毒。
在25名患者发生的44次发热性中性粒细胞减少症发作中，25%检测到呼吸道病毒。检测到的病毒有：流感（3/11）、副流感（3/11）、呼吸道合胞病毒（2/11）、腺病毒（1/11）、副流感 + 呼吸道合胞病毒（1/11）以及副流感 + 腺病毒（1/11）。4例（36%）为医院感染。9名儿童出现呼吸道症状，其中7名有下呼吸道症状。1例患者死于持续性呼吸道合胞病毒感染、粒细胞缺乏症和广泛的双侧肺炎。
在急性淋巴细胞白血病儿童的发热性中性粒细胞减少症发作中，25%检测到呼吸道病毒。如此高的检测率，加上下呼吸道频繁受累以及死亡的可能性，强烈支持在秋冬季节对这些儿童进行评估时纳入呼吸道病毒诊断检测。
