scholarly journals Fatal lower respiratory tract disease with human corona virus NL63 in an adult haematopoietic cell transplant recipient

2009 ◽  
Vol 45 (6) ◽  
pp. 1115-1116 ◽  
Author(s):  
L Oosterhof ◽  
C B Christensen ◽  
H Sengeløv
Keyword(s):  
Transplant Recipient ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Cell Transplant ◽  
Respiratory Tract Disease ◽  
Haematopoietic Cell ◽  
Corona Virus ◽  
Lower Respiratory Tract Disease ◽  
Tract Disease

Respiratory Synctial Virus (RSV) Infection in Hematopoietic Stem Cell Transplant (HCT) Recipients: Risk Factors for Acquisition and Lower Respiratory Tract Disease, and Impact on Mortality.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 187-187 ◽  
Author(s):  
Michael J. Boeckh ◽  
Ted Gooley ◽  
Janet Englund ◽  
Jason W. Chien ◽  
Stephen W. Crawford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Cell Transplant ◽  
Upper Respiratory Tract ◽  
Respiratory Tract Disease ◽  
Hematopoietic Stem ◽  
Lower Respiratory Tract Disease ◽  
Tract Disease

Abstract RSV lower respiratory tract disease (LRTD) is a serious complication after HCT. Risk factors for virus acquisition and progression from RSV upper respiratory tract infection (URI) to RSV LRTD are poorly defined. A targeted surveillance system consisting of routine virologic evaluation for RSV (DFA, shell vial assay, culture) in HCT recipients with URI symptoms was instituted in 10/89. We retrospectively analyzed risk factors of RSV acquisition and the development of RSV-LRTD among patients with RSV-URI between 10/89 and 7/02. From 10/94 to 7/97, patients with RSV-URI received preemptive aerosolized ribavirin (2g/day) for 5–7 d; some patients received full-dose preemptive ribavirin (6g/day). All results are from multivariable models. One hundred forty-seven of 4717 (3.1%) patients were diagnosed with RSV URI and/or LRTD during the first 100 days after HCT. Risk factors for RSV acquisition included bone marrow vs. peripheral blood stem cell (PBSC) (1.7, P=0.01), winter season (P<0.0001), the years 1993 and 1997 when 2 outbreaks occurred (HR 1.7, P=0.01), male sex (HR 1.4, P=0.06). Laminar airflow rooms (HR 0.5, P=0.004) and the period after 1997 (HR 0.65, P=0.09) were protective against acquisition (after 1997, we started to restrict patient contact with staff and caretakers who had an URI with uncontrolled secretions). Risk factors for RSV-LRTD among infected patients included age > 20 year (OR 3.2, P=0.02) and lymphocytopenia < 100/mm3 (OR 4.7, P=0.0005). To assess risk factors for progression from RSV-URI to LRTD, patients who presented with RSV-URI were examined. Lymphocytopenia < 100/mm3 was the only statistically significant factor (OR 14, P<0.001) associated with progression; use of preemptive ribavirin (low- or high-dose) was not statistically significantly associated with a lower progression rate. The development of RSV LRTD as a time-dependent variable was associated with increased mortality after HCT (HR 2.2, p < 0.001), after controlling for age, underlying disease status, donor match and type, conditioning regimen, stem cell source, and CMV serostatus. Thus, RSV acquisition is less common with PBSC transplantation and in a strict isolation setting. Restricting recipients’ contact to people with uncontrolled respiratory secretions in the outpatient setting may be beneficial; further studies are needed to confirm this. Lymphocytopenia is an important risk factor for progression from URI to LRTD and RSV-LRTD is independently associated with mortality after HCT.

Clinical Characteristics of the Afebrile Pneumonia Associated With Chlamydia trachomatis Infection in Infants Less Than 6 Months of Age

PEDIATRICS ◽  
1979 ◽  
Vol 63 (2) ◽  
pp. 192-197
Author(s):  
Margaret A. Tipple ◽  
Marc O. Beem ◽  
Evelyn M. Saxon
Keyword(s):  
Chlamydia Trachomatis ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Clinical Characteristics ◽  
Respiratory Tract Disease ◽  
Chlamydia Trachomatis Infection ◽  
Lower Respiratory Tract Disease ◽  
Tract Disease ◽  
Blood Eosinophils ◽  
Respiratory Tract Colonization

Respiratory tract colonization with Chlamydia trachomatis commonly occurs in natally acquired chlamydial infection and is sometimes associated with a chronic, afebrile pneumonia that has relatively distinctive clinical characteristics. To further define the frequency and clinical characteristics of lower respiratory tract disease associated with C trachomatis, we grouped 56 infants aged less than 6 months with afebrile pneumonia according to nasopharyngeal shedding of Chlamydia and viruses and compared their illnesses. Forty-one (73%) were positive for C trachomatis (23 had C trachomatis only, while 18 had C trachomatis plus a virus [cytomegalovirus, respiratory synctial virus, adenovirus, rhinovirus, or enterovirus]), and 15 were C trachomatis negative (nine had a virus only, and six had neither C trachomatis nor virus). The 41 infants with C trachomatis alone or C trachomatis plus a virus were similar clinically and differed significantly from other infants in several ways: (1) onset of symptoms before 8 weeks of age; (2) gradually worsening symptoms; (3) presentation for care at 4 to 11 weeks of age; (4) presence of conjunctivitis and ear abnormalities; (5) chest roentgenograms showing bilateral, symmetrical, interstitial infiltrates and hyperexpansion; (6) peripheral blood eosinophils ≥300/cu mm; and (7) elevated values for serum immunoglobulins M, G, and A.

Weight Status and Risk of Inpatient Admission for Children With Lower Respiratory Tract Disease

2021 ◽  
Author(s):  
Elizabeth E. Halvorson ◽  
Amit Saha ◽  
Christopher B. Forrest ◽  
Hanieh Razzaghi ◽  
Suchitra Rao ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hospital Admission ◽  
Lower Respiratory Tract ◽  
Normal Weight ◽  
Research Network ◽  
Respiratory Tract Disease ◽  
Weight Category ◽  
Lower Respiratory Tract Disease ◽  
Class 1 ◽  
Tract Disease

OBJECTIVES To identify associations between weight category and hospital admission for lower respiratory tract disease (LRTD), defined as asthma, community-acquired pneumonia, viral pneumonia, or bronchiolitis, among children evaluated in pediatric emergency departments (PEDs). METHODS We performed a retrospective cohort study of children 2 to &lt;18 years of age evaluated in the PED at 6 children’s hospitals within the PEDSnet clinical research network from 2009 to 2019. BMI percentile of children was classified as underweight, healthy weight, overweight, and class 1, 2, or 3 obesity. Children with complex chronic conditions were excluded. Mixed-effects multivariable logistic regression was used to assess associations between BMI categories and hospitalization or 7- and 30-day PED revisits, adjusted for covariates (age, sex, race and ethnicity, and payer). RESULTS Among 107 446 children with 218 180 PED evaluations for LRTD, 4.5% had underweight, 56.4% had healthy normal weight, 16.1% had overweight, 14.6% had class 1 obesity, 5.5% had class 2 obesity, and 3.0% had class 3 obesity. Underweight was associated with increased risk of hospital admission compared with normal weight (odds ratio [OR] 1.76; 95% confidence interval [CI] 1.69–1.84). Overweight (OR 0.87; 95% CI 0.85–0.90), class 1 obesity (OR 0.88; 95% CI 0.85–0.91), and class 2 obesity (OR 0.91; 95% CI 0.87–0.96) had negative associations with hospital admission. Class 1 and class 2, but not class 3, obesity had small positive associations with 7- and 30-day PED revisits. CONCLUSIONS We found an inverse relationship between patient weight category and risk for hospital admission in children evaluated in the PED for LRTD.

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