Associations between patient clinical characteristics and the presence of cytomegalovirus DNA in the bronchoalveolar lavage fluid of children with recurrent wheezing

Sun, Hongwei; Li, Shuxiang; Wang, Yuqing; Hao, Chuangli; Ji, Wei

doi:10.1186/s12879-018-3345-9

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…We found a higher percentage of blood eosinophils among young infants who were a icted with CMV, which was consistent with a hypothesis linking CMV infection with asthma-like Th2 in ammatory responses 31 . The immature immune system or congenital immunode ciencies of young children might not be able to suppress CMV replication after primary infection, which offers a potential explanation for our observations of higher morbidity of CMV infections in the younger age group of children 31 . Previous study demonstrated that CMV reactivation was associated with asthma or recurrent wheeze 32 .…”

Section: Discussionsupporting

confidence: 91%

Increased Peripheral Blood Eosinophils may Indicate Acute Infection in Neonates

Wang¹,

Yuan²,

Yuan³

2021

Preprint

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Objective To explore the association between increased blood eosinophils and frequent pathogens due to the infections in children. Methods A total of 2353 children with acute infections admitted to Guangzhou Women and Children's Medical Center from February 1, 2019 to January 31, 2020 were enrolled in the study. 277 children without infections were comprised the control group. Children’s age, peripheral blood parameters including white blood cells, eosinophils, C-reactive protein (CRP) were recorded. In addition, infection stage and departments the patients admitted to were investigated. Results Blood eosinophil numbers negatively correlated with the age of children, whereas had no relation to disease stage. The means of eosinophil for neonates (<0.1 year)，infancy (<1year) and children >1year with acute infections were 0.67±0.40, 0.40±0.68, 0.15±0.25 *109/L compared with control group matched for age(0.44±0.20, 0.45±0.27, 0.24±0.19*109/L, P <0.001, <0.001, 0.497, respectively). Among them, the mean of eosinophil in the neonates afflicted with acute infections was significantly higher than the others compared to age-matched controls (0.63±0.60 vs 0.44±0.20, P= 0.012). Areas under the curves (AUC) were 0.81 (95% CI 0.75–0.86) for eosinophil combined with CRP and 0.68 (95% CI 0.61–0.75) for CRP alone for acute infections in neonates (P=0.02). Patients admitted in ICU had higher eosinophils than outpatients (0.46±0.60 vs 0.16±0.24, P <0.001) but had no significant difference compared with control group (0.45±0.20, P >0.99). Conclusion Increased peripheral blood eosinophils may indicate acute infections among neonates. Eosinophil combined with CRP can contribute to evaluating this population.

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Section: Discussionsupporting

confidence: 91%

Increased Peripheral Blood Eosinophils may Indicate Acute Infection in Neonates

Wang¹,

Yuan²,

Yuan³

2021

Preprint

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“…Of note in our study is that three of the eight CCMV patients had congenital stridor (38%, 3/8), two of which were caused by laryngomalacia (I). There have been no reports to date regarding CCMV infections causing congenital stridor; however, several studies have reported an association between CMV infection / reactivation and wheezing in immunocompetent infants 4 . The association between CCMV infection and congenital stridor therefore remains unclear.…”

Section: Patient No) Sex Age Gestational Age Birth Weight Age At Diagmentioning

confidence: 99%

Congenital stridor induced by cytomegalovirus infection

Kashiwagi

Nara

Suganami

et al. 2021

Pediatrics International

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When a pregnant woman who does not have the cytomegalovirus (CMV) antibody is infected with CMV for the first time, the risk of congenital CMV (CCMV) infection of the fetus is increased. It has been demonstrated that many asymptomatic children with CCMV infection remain undiagnosed. In Japan, the umbilical cord is kept at home as a symbol of the motherchild bond, and it has been reported that CMV DNA can be detected from the umbilical cord very efficiently. As CMV DNA has never been detected in umbilical cord samples taken from noninfected healthy newborns, 1 it should be possible to use preserved umbilical cords for the retrospective diagnosis of CCMV infection. Morisawa et al. demonstrated that primary CMV infection was found more often in the wheezers than in the controls, 2 however, the frequency of CCMV infection-associated congenital stridor has never been studied.

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“…Lung CMV infections have variable severity. Whereas mild lung infections may remain unnoticed or present as a self-resolved respiratory infections [17,18], severe involvement is characterized by respiratory failure frequently requiring invasive ventilatory support [19]. CMV pneumonia should be suspected when degrees of hypoxemia do not correlate with the appearance and distribution of the infiltrates in chest radiographs.…”

Section: The Clinical Spectrum Of Pediatric Lung Cytomegalovirus Infementioning

confidence: 99%

Challenges and Clinical Implications of the Diagnosis of Cytomegalovirus Lung Infection in Children

Restrepo

Gutiérrez

Osorio

et al. 2019

Curr Infect Dis Rep

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Purpose of Review-Pulmonary cytomegalovirus (CMV) infection is a potential lethal disease in children, but it remains a diagnostic challenge. The differentiation between latent CMV infections with viral shedding and active infections is difficult and may lead to false positives in bronchoalvolar lavage (BAL) PCR detection. This review summarizes current diagnostic approaches for CMV lung infection in children including progress in the identification of underlying immune defects linked to this condition. Recent Findings-There is increasing literature supporting that the combined assessment of host risk factors and lung disease pattern is essential for the diagnosis of pulmonary CMV infection in children. The most important host risk factor is an immunecompromised state that has expanded from primary or acquired immunodeficiency (e.g., HIV) to include a myriad of immunedysregulation syndromes (e.g., CTLA4, PIK3 defects). Newborns, paricularly those born premature, are also a high-risk group. At the pulmonary level, active CMV infection is typically characterized by alveolar compromise leading to hypoxemia, ground-glass opacities, and intraalveolar infiltrates with CMV inclusions in lung biopsy. The identification of active CMV lung infection should trigger additional evaluation of immune defects (primary or secondary) impairing T and NK cell function or innate antiviral responses as well as other immune dysregulation disorders. Summary-Lung CMV infections in children are more prevalent in immunocompromised hosts and premature newborns. Lung CMV infections should prompt further investigation into conditions altering immune mechanisms usually in place to contain CMV infections. Common ✉ Gustavo Nino,

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Associations between patient clinical characteristics and the presence of cytomegalovirus DNA in the bronchoalveolar lavage fluid of children with recurrent wheezing

Cited by 10 publications

References 16 publications

Increased Peripheral Blood Eosinophils may Indicate Acute Infection in Neonates

Increased Peripheral Blood Eosinophils may Indicate Acute Infection in Neonates

Congenital stridor induced by cytomegalovirus infection

Challenges and Clinical Implications of the Diagnosis of Cytomegalovirus Lung Infection in Children

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