Significant morbidity associated with RSV infection in immunosuppressed children following liver transplantation: Case report and discussion regarding need of routine prophylaxis

Abstract

Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infection in infants and young children. In immunocompromised children, RSV infection poses a serious health threat with significantly increased and prolonged virus shedding and the development of severe respiratory disease. We report two patients, eight months and 20 months of age, who were admitted with severe RSV infection two months and 10 months post-transplant respectively. Major risk factors for severe infection is the degree of immunosuppression and the age of the patient (<24 months). Based on the significant morbidity associated with RSV infection in these patients, we recommend randomized trials in larger pediatric solid organ transplant centers to evaluate the use of palivizumab prophylaxis is efficacious to prevent morbidity in patients under the age of 24 months, while we emphasize good hygienic practices to prevent RSV nosocomial infection.

Respiratory Syncytial Virus Infections in Infants Affected by Primary Immunodeficiency

“…Moreover, in epidemic seasons immunocompromised infants and children should be hospitalized in special designated areas where other patients, caregivers, and visitors should be checked for respiratory infections and where the admission of visitors is limited [59]. …”

Monitoring and managing viral infections in pediatric renal transplant recipients

“…Detecting the specific viral pathogen is crucial for diagnosis, and although conventional methods such as immunofluorescence and enzyme-linked immunosorbent assay (ELISA) are still commonly used, molecular methods -in particular, real-time PCR -have proven significantly more sensitive [86]. Among respiratory viruses, respiratory syncytial virus (RSV), influenza viruses (IV), parainfluenza viruses (PIV), and adenoviruses (AdV) cause the most serious disease in immunocompromised hosts [85,[87][88][89]. Complications include severe pneumonia (RSV, IV, PIV, AdV), and, in kidney recipients, pyelonephritis, hemorrhagic cystitis, and disseminated disease (AdV), although incidence is generally low and disease may be mild in this cohort.…”

Viral infections in paediatric patients receiving conventional cancer chemotherapy

“…Prolonged symptomatic23 24 and asymptomatic21 25 26 shedding of contagious virus particles is often observed in immunocompromised children. This phenomenon may for last weeks or month and contributes significantly to the risk of nosocomial transmission.…”