Englund J A, Sullivan C J, Jordan M C, Dehner L P, Vercellotti G M, Balfour H H
University of Minnesota Health Sciences Center, Minneapolis.
Ann Intern Med. 1988 Aug 1;109(3):203-8. doi: 10.7326/0003-4819-109-3-203.
Respiratory syncytial virus disease was documented in 11 immunocompromised adults, aged 21 to 50. Underlying conditions included bone marrow transplant (6 patients), renal transplant (3 patients), renal and pancreas transplants (1 patient), and T-cell lymphoma (1 patient). Diagnosis of infection was based on specimens from bronchoalveolar lavage, sputum, throat, sinus aspirate, and lung biopsy. The virus was detected simultaneously by antibody in either an immunofluorescence or enzyme-linked immunosorbent assay in 3 of 4 patients whose culture results were positive for respiratory syncytial virus. The virus was an unexpected finding, despite widespread infection in the community. Clinical symptoms included low-grade fever, nonproductive cough, rhinorrhea or nasal congestion, and radiographic evidence of interstitial infiltrates and sinusitis. Aerosolized ribavirin therapy was used in the 6 recipients of bone marrow transplants, 3 of whom required assisted ventilation but died. Death caused by virus infection was documented in 4 of 11 patients. Respiratory syncytial virus disease must be considered in the differential diagnosis of fever and pulmonary infiltrates in immunocompromised adults.
在11名21至50岁的免疫功能低下成人中记录到呼吸道合胞病毒病。基础疾病包括骨髓移植（6例患者）、肾移植（3例患者）、肾和胰腺移植（1例患者）以及T细胞淋巴瘤（1例患者）。感染诊断基于支气管肺泡灌洗、痰液、咽喉、鼻窦抽吸物和肺活检的标本。在呼吸道合胞病毒培养结果呈阳性的4例患者中，有3例通过免疫荧光或酶联免疫吸附试验同时检测到抗体中的病毒。尽管该病毒在社区中广泛感染，但它仍是一个意外发现。临床症状包括低热、干咳、流涕或鼻塞，以及间质性浸润和鼻窦炎的影像学证据。6例骨髓移植受者使用了雾化利巴韦林治疗，其中3例需要辅助通气但死亡。11例患者中有4例记录为由病毒感染导致的死亡。在免疫功能低下成人发热和肺部浸润的鉴别诊断中必须考虑呼吸道合胞病毒病。
