Effects of respiratory viruses on febrile neutropenia attacks in children

Abstract

Respiratory tract viruses have an important effect on morbidity and mortality in patients with febrile neutropenia (FN). The aim of this study was to determine frequency and clinical influence of viral respiratory viruses as potential etiologic agents in episodes of FN in children. A total of 100 children (62 boys, 38 girls) with 166 FN episodes were included in this prospective study. Nasopharyngeal aspirate samples were analyzed for respiratory viral agents using multiplex real-time polymerase chain reaction. The origin of the fever could be defined in 111 (67%) of the episodes. We detected viral agents in 86 (51.8%), bacterial agents in 19 (11.4%), and fungal agents in 5 (3%) of the episodes. The most common detected viruses were rhinovirus (n= 27), respiratory syncytial virus (n=17), and coronavirus (n=16). Parainfluenza virus, influenza A and B, adenovirus, human metapneumovirus, enterovirus, bocavirus and parechovirus were the remaining detected agents. More than one virus positivity occurred in 13 FN episodes. Forty-three patients had multiple FN episodes. Only four patients had the same viral agent in consecutive attacks. Respiratory symptoms (cough, nasal discharge and congestion, sneezing, wheezing), physical examination signs (rales and rhonchi) and radiological findings were significantly more common in viral agent positive patients (p < 0.05). This study showed that respiratory viruses make a substantial contribution on the etiology of FN episodes in children. Identifying viral agents may help to constitute individualized infection-management algorithms in these patients.

Investigation of respiratory syncytial virus in children with respiratory tract infection by real-time polymerase chain reaction

“…In the studies conducted in our country, viral etiology is observed at a rate between 41.8% and 85% in acute RTIs. Also in these studies, RSV was found at a rate between 0% and 63% in different age groups (Table 4) [16][17][18][19][20][21][22][23]. In our study, we found RSV in 14% (390/2707) of the children diagnosed with RTI in the age group of 0-18.…”

Genetic Sequence Variants in TLR4, MBL or IL-1 Receptor Antagonist is not Associated to Increased Risk for Febrile Neutropenia in Children with ALL

“…Several previous studies have reported that viral (mainly respiratory) infections are the most commonly verified infection (44-50%) during FN [6,[29][30][31][32][33]. The lower proportion of viral infections in this study could be explained by different methods used for viral detection during the study period and that viral sampling was less stringent compared to blood culture sampling.…”

Clinical Epidemiology Characteristics and Etiology of Febrile Neutropenia in Children: Analysis of 421 Cases

“…Conversely, measles, rotavirus, and Epstein–Barr virus were less frequent. Aldemir-Kocabas [ 16 ] and Suryadevara demonstrated a similar pattern, with respiratory virus percentages of 51.8% and 52%, respectively. According to Walkovich and Boxer [ 23 ], the most common cause of acute neutropenia among children is infectious diseases, and viruses such as RSV , Varicella , Influenza type A and type B , measles , and EBV are the primary agents that commonly cause neutropenia.…”

“…In addition, we noticed that the number of males was higher than that of females, and the male-to-female ratio was 1.35/1, which followed the same trend as previous studies. In his investigation, Aldemir-Kocabas [ 16 ] found that the male–female ratio was 1.6/1, while Angelino [ 17 ] found that it was 1.21.…”

“…According to Dale and Bolyard’s 2017 study on common respiratory pathogens among febrile neutropenic children, only two-thirds of the causes of fever were detected in all of the studied children, with viruses accounting for 51.8%, bacteria for 11.4%, and fungi for 3% [ 15 ]. The most common viral etiology was rhinovirus, followed by respiratory syncytial virus and coronavirus [ 16 ].…”