TY - JOUR
T1 - Clinical features of human metapneumovirus pneumonia in non-immunocompromised patients
T2 - An investigation of three long-term care facility outbreaks
AU - Karimata, Yosuke
AU - Kinjo, Takeshi
AU - Parrott, Gretchen
AU - Uehara, Ayako
AU - Nabeya, Daijiro
AU - Haranaga, Shusaku
AU - Higa, Futoshi
AU - Tateyama, Masao
AU - Miyagawa, Keiko
AU - Kishaba, Tomoo
AU - Otani, Kanako
AU - Okamoto, Michiko
AU - Nishimura, Hidekazu
AU - Fujita, Jiro
N1 - Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2018/8/14
Y1 - 2018/8/14
N2 - Background. Several studies have reported outbreaks due to human metapneumovirus (hMPV) in long-term care facilities (LTCF) for the elderly. However, most of these reports are epidemiological studies and do not investigate the clinical features of hMPV pneumonia. Methods. Three independent outbreaks of hMPV occurred at separate LTCF for intellectually challenged and elderly residents. A retrospective evaluation of hMPV pneumonia and its clinical and radiological features was conducted using available medical records and data. Results. In 105 hMPV infections, 49% of patients developed pneumonia. The median age of pneumonia cases was significantly higher than non-pneumonia cases (P < .001). Clinical manifestations of hMPV pneumonia included high fever, wheezing in 43%, and respiratory failure in 31% of patients. An elevated number of white blood cells as well as increased levels of C-reactive protein, creatine phosphokinase, and both aspartate and alanine transaminases was also observed among pneumonia cases. Evaluation of chest imaging revealed proximal bronchial wall thickenings radiating outward from the hilum in most patients. Conclusions. The aforementioned characteristics should be considered as representative of hMPV pneumonia. Patients presenting with these features should have laboratory testing performed for prompt diagnosis.
AB - Background. Several studies have reported outbreaks due to human metapneumovirus (hMPV) in long-term care facilities (LTCF) for the elderly. However, most of these reports are epidemiological studies and do not investigate the clinical features of hMPV pneumonia. Methods. Three independent outbreaks of hMPV occurred at separate LTCF for intellectually challenged and elderly residents. A retrospective evaluation of hMPV pneumonia and its clinical and radiological features was conducted using available medical records and data. Results. In 105 hMPV infections, 49% of patients developed pneumonia. The median age of pneumonia cases was significantly higher than non-pneumonia cases (P < .001). Clinical manifestations of hMPV pneumonia included high fever, wheezing in 43%, and respiratory failure in 31% of patients. An elevated number of white blood cells as well as increased levels of C-reactive protein, creatine phosphokinase, and both aspartate and alanine transaminases was also observed among pneumonia cases. Evaluation of chest imaging revealed proximal bronchial wall thickenings radiating outward from the hilum in most patients. Conclusions. The aforementioned characteristics should be considered as representative of hMPV pneumonia. Patients presenting with these features should have laboratory testing performed for prompt diagnosis.
KW - Bronchial wall thickenings
KW - Human metapneumovirus
KW - Long-term care facility
KW - Outbreak
KW - Pneumonia
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U2 - 10.1093/infdis/jiy261
DO - 10.1093/infdis/jiy261
M3 - Article
C2 - 29733351
AN - SCOPUS:85055314412
VL - 218
SP - 868
EP - 875
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
SN - 0022-1899
IS - 6
ER -