SESSION TITLE: Respiratory Infections
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Tuesday, October 28, 2014 at 11:00 AM - 12:15 PM
PURPOSE: The aim of this study was to describe the clinical characteristics of young adults with documented human Metapneumovirus (hMPV) infection at our institution.
METHODS: This retrospective analysis was done at University of North Carolina. Charts of patients who tested positive for hMPV by Luminex xTAG RVP assay from 1/1/2009 through 02/28/2014 were analyzed. Demographics, symptoms/signs, comorbidities, hospital course, treatment and disposition were recorded.
RESULTS: Total 33 patients tested positive for hMPV during the study period. The incidence peaked in late winter and early spring. The mean age of these patients was 51+/- 21 (SD). There were 22 Caucasians, 7 African Americans and 4 Asians. The most common presenting symptoms in these patients were cough 24/33 (73%), dyspnea 20/33 (61%) and fever 20/33 (61%). Total 9/33 (27%) patients had underlying chronic lung disease. Seven patients (21%) had a history of malignancy and seven patients (21%) were on immunosuppressant medications. Mean FEV1 was 72% +/- 25 (SD) predicted in patients with chronic lung disease. On initial presentation chest radiographs revealed bilateral infiltrates in 11/33 (33%) unilateral infiltrate in 10/33 (30%) and no infiltrate in 12/33 (36%). Ten patients (30%) required ICU care, of which 7 were intubated. Five patients underwent bronchoscopy. Two patients had concomitant rhinovirus infection, one had concomitant adenovirus and one had influenza A. Two (6%) ICU patients died during their hospitalization. Total 30/33 patients in the study were treated with antibiotics and 15/33 received steroids. Four patients (12%) were treated with ribavirin. Five patients were empirically treated with oseltamivir.
CONCLUSIONS: Human Metapneumovirus is a common pathogen which often presents with cough dyspnea and infiltrate on chest radiograph. Though adults hospitalized with hMPV often have multiple co-morbidities, previously healthy patients and younger adult patients still need to be considered for this illness.
CLINICAL IMPLICATIONS: Human Metapneumovirus infections should be kept in differentials in patients presenting with cough, dyspnea and chest infiltrate. Among individuals requiring ICU care, high mortality is a concern.
DISCLOSURE: The following authors have nothing to disclose: Vikas Pathak, Anna Conterato, Robert Aris
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