1/8. rhinovirus infections in myelosuppressed adult blood and marrow transplant recipients.Scant data are available on the clinical significance of rhinovirus infections in immunocompromised patients. We reviewed the clinical courses of and outcomes for 22 myelosuppressed adult blood and marrow transplant recipients with rhinovirus infections who were hospitalized at the M.D. Anderson Cancer Center (Houston) from January 1992 to January 1997. In 15 patients (68%), illnesses remained confined to the upper respiratory tract. Seven patients (32%) developed fatal pneumonia. These patients had profound respiratory failure a mean of 12 days (range, 3-21 days) after the onset of symptoms. In six of these seven cases, rhinovirus was isolated before death from a bronchoalveolar lavage fluid specimen and/or an endotracheal aspirate. Five patients underwent autopsies, one of which revealed disseminated aspergillosis and four of which revealed interstitial pneumonitis and/or acute respiratory distress syndrome and no other organisms. In conclusion, rhinovirus infections may be associated with considerable pulmonary-related morbidity and mortality in severely myelosuppressed immunocompromised patients.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/8. Clinical features of patients with acute respiratory illness and rhinovirus in their bronchoalveolar lavages.BACKGROUND: Several reports in selected populations suggest that human rhinovirus (HRV) may be responsible for lower respiratory tract infections or pneumonia. We describe clinical features of all patients with rhinovirus cultured from their bronchoalveolar lavage (BAL) during a 10-yr period in a tertiary care center. methods: Results for viral culture of all lower respiratory specimens performed during a 10-year period at the University of virginia health Sciences Center were reviewed. A case was defined as any patient with a positive culture for HRV in a BAL specimen. A comprehensive review of the patients' medical records was performed. In one case, in situ hybridization (ISH) was performed in order to identify whether rhinoviral rna was present in bronchial biopsy specimens. RESULTS: During the 10-year study period viruses were identified in 431 lower respiratory tract specimens, and were most frequently cytomegalovirus or herpes simplex virus. Twenty patients (ages, 2.5-86 year) had a bronchoalveolar specimen culture positive for HRV. All had an abnormal chest radiograph, 60% were admitted to the intensive care unit, and 25% expired during their hospitalization. In 18 patients (90%) various severe underlying conditions were identified including solid organ transplants in seven, malignancies in four and AIDS in two. An immunosuppressive disease or condition requiring immunosuppressive therapy was present in all cases. In addition to HRV, one or more potential pathogens were identified in respiratory specimens from 14 patients (70%). Histopathological abnormalities, ranging from fibropurulent debris in alveoli to diffuse alveolar damage, were present in 6 of 13 bronchial biopsies. In two cases without any other significant pathogens than HRV, acute inflammations with fibropurulent debris in alveoli were observed. One lung transplant patient showed intermittent recovery of HRV in her respiratory specimens during a 15-week time period, but ISH did not show HRV rna in bronchial epithelial cells. CONCLUSION: Our observations suggest that HRV recovery from BALs or lower respiratory tract samples in highly immunocompromised patients is associated with severe lower respiratory tract illness. Whether HRV directly causes viral pneumonia or predispose to pulmonary injury and/or superinfection remains uncertain.- - - - - - - - - - ranking = 0.28571428571429keywords = infection (Clic here for more details about this article) |
3/8. Virus-induced asthma attacks.Viral respiratory tract infections are a common cause of asthma attacks. Study of this phenomenon has revealed multiple mechanisms and contributed to understanding of the increase in airway inflammation and bronchoconstriction observed in this context. Changes in the neural control of the airways contribute to bronchoconstriction, which is reflected in an increased efficacy of anticholinergic medications during acute asthma attacks. The ability to prevent or treat viral respiratory tract infections is currently limited. However, as more effective antiviral treatments and vaccines become available, such therapies are likely to be effective in patients with asthma. Clinical management of this problem is illustrated in this article by the case of a 40-year-old woman with history of mild asthma who was admitted to an intensive care unit with severe bronchospasm and an upper respiratory tract infection.- - - - - - - - - - ranking = 0.42857142857143keywords = infection (Clic here for more details about this article) |
4/8. encephalomyelitis due to human parechovirus type 1.OBJECTIVES: The implication of a viral agent in encephalomyelitis has been reported for several years. In the present study we wanted to demonstrate the presence of human parechovirus type 1 (HPEV1) in a patient diagnosed with encephalomyelitis. STUDY DESIGN: Clinical samples (throat and rectal swabs, acute and convalescent sera, cerebrospinal fluid) were collected from a 10-month-old boy diagnosed with encephalomyelitis. The appropriated samples were tested for cytomegalovirus, varicella zona virus, mumps virus and enteroviruses with specific culture, and serological and molecular biological techniques. RESULTS: HPEV1 was isolated from the throat and its genome was additional detectable in the cerebrospinal fluid, throat swab and acute serum. The samples were negative for all other tested viruses. CONCLUSION: To our knowledge, this is the first reported case of HPEV1 infection related to encephalomyelitis. This emphasis that human parechoviruses can be responsible for severe central nervous system infections in children.- - - - - - - - - - ranking = 0.28571428571429keywords = infection (Clic here for more details about this article) |
5/8. Human parechovirus 3 and neonatal infections.A third serotype of human parechovirus (HPeV) has been recently isolated from stool specimens of a young Japanese child with transient paralysis. We report 3 additional cases of neonatal sepsis caused by HPeV-3 in the fall of 2001 in Canadian infants 7-27 days old. All children were hospitalized with high fever, erythematous rash, and tachypnea for a median of 5 days. The viruses isolated from nasopharyngeal aspirates grew slowly on tertiary monkey kidney cells and were successfully passaged on vero cells. The predicted amino acid identity of the VP0-VP3-VP1 region of the three viruses was 74.6%-74.8%, 73.4%-73.6%, and 97.0%-97.1% when compared to HPeV-1, -2, and -3 prototype strains, respectively. Although different, our isolates were closely related; amino acid identity was 99.6%-100% for the last 3 proteins.- - - - - - - - - - ranking = 0.57142857142857keywords = infection (Clic here for more details about this article) |
6/8. Sudden death of an infant with rhinovirus infection complicating bronchial asthma: case report.An 11-month-old infant with symptoms of mild asthma for 3 months died unexpectedly during sleep. Pulmonary findings typical of acute asthma as well as focal interstitial pneumonitis were present at autopsy. serum IgE level, known to rise in viral infections, was markedly elevated. rhinovirus type 47 was cultured from blood and lung post mortem. The relationship between viral infection and onset of an acute asthmatic attack is discussed, and this potentially life-threatening complication of asthma is underscored.- - - - - - - - - - ranking = 0.85714285714286keywords = infection (Clic here for more details about this article) |
7/8. Pancreatic islet-cell damage in children with fatal viral infections.The pancreases from 250 children with fatal infections caused by at least fourteen different viruses were examined for lesions in the islets of langerhans. Viral cytopathology was found in 4 of 7 cases of Coxsackievirus B infection, 20 of 45 cases of cytomegalovirus infection, 2 of 14 cases of varicella-zoster infection, and 2 of 45 cases of congenital rubella. Destruction of beta cells and acute and chronic inflammatory infiltrates were found in islets from cases with Coxsackievirus B infections. Characteristic inclusion bodies were observed in islets from cases with cytomegalovirus and varicella-zoster infections. This survey provides further evidence that some viruses can infect and damage human beta cells.- - - - - - - - - - ranking = 1.4285714285714keywords = infection (Clic here for more details about this article) |
8/8. Simultaneous streptococcus and picornavirus infection. Muscle involvement in acute rhabdomyolysis.Streptococci seldom invade muscle in healthy people with intact integument. However, infection with another agent simultaneously may change this general observation. In a two-week period we encountered dual infections with group A, beta-hemolytic streptococci and a picornavirus in each of two hospitalized patients. Both were acutely ill; one died. Renal failure developed in the patient who survived and rhabdomyolysis was demonstrated in the patient who died. Picornavirus titer increases were demonstrated in the patient who survived, and viral inclusions in muscle cells were demonstrated by light microscopy in necropsy specimens and confirmed by electron microscopy in the second patient. We believe that streptococcal invasion of muscle may be facilitated during an outbreak of certain picornavirus infections.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |