Teranishi Hideto, Ohzono Nanae, Miyata Ippei, Wakabayashi Shoko, Kono Mina, Ono Sahoko, Kato Atsushi, Saito Aki, Kondo Eisuke, Tanaka Yuuhei, Akaike Hiroto, Oishi Tomohiro, Ohno Naoki, Terada Kihei, Ouchi Kazunobu
Department of Pediatrics, Kawasaki Medical School, Kurashiki, Japan.
J Pediatr Hematol Oncol. 2018 Nov;40(8):605-608. doi: 10.1097/MPH.0000000000001300.
Although febrile neutropenia (FN) is one of the most common adverse events produced by chemotherapy, its microbiological etiology is determined for only 15% to 30% of cases.
We investigated the rate of viremia with common DNA viruses in patients with FN.
From June 2012 to April 2014, 72 blood samples from 24 patients receiving chemotherapy, who experienced FN episodes, were examined for the presence of herpes viruses and other DNA viruses. We used real-time polymerase chain reaction assays to detect herpes simplex virus type 1 and 2, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, human herpes virus types 6 and 7, BK virus and human parvovirus B19 (B19).
Viruses were identified in 14 of 72 samples (19.4%). The detected etiological agents were BK virus (5 episodes), human herpes virus type 6 (4 episodes), B19 (4 episodes), Epstein-Barr virus (2 episodes), and cytomegalovirus (1 episode).
Our results indicate that viral infections are common causes in patients with FN. Therefore, viruses may be responsible for FN in a large proportion of patients in whom a causative microorganism could not be identified, and this viral etiology may explain their poor response to antibiotic therapy.
尽管发热性中性粒细胞减少症（FN）是化疗最常见的不良事件之一，但其微生物病因仅在15%至30%的病例中得以明确。
我们调查了FN患者中常见DNA病毒的病毒血症发生率。
2012年6月至2014年4月，对24例接受化疗且经历FN发作的患者的72份血样进行检测，以确定是否存在疱疹病毒和其他DNA病毒。我们使用实时聚合酶链反应检测法来检测1型和2型单纯疱疹病毒、水痘带状疱疹病毒、爱泼斯坦-巴尔病毒、巨细胞病毒、人类疱疹病毒6型和7型、BK病毒以及人细小病毒B19（B19）。
72份样本中有14份（19.4%）检测出病毒。检测到的病原体为BK病毒（5例）、人类疱疹病毒6型（4例）、B19（4例）、爱泼斯坦-巴尔病毒（2例）和巨细胞病毒（1例）。
我们的结果表明，病毒感染是FN患者的常见病因。因此，在很大一部分无法确定致病微生物的患者中，病毒可能是FN的病因，这种病毒病因可能解释了他们对抗生素治疗反应不佳的原因。
