ABSTRACT
The lymphotropic herpesviruses, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 6B (HHV-6B) can reactivate and cause disease in organ transplant recipients; the contributions of HHV-6A and HHV-7 to disease are less certain. Less is known about their pathogenic roles in children undergoing treatment for malignancies. Children with newly diagnosed cancer were followed for 24 months. Clinical information and blood samples were collected during routine visits and during acute visits for fever or possible viral infections. Lymphotropic herpesvirus DNA in blood was measured by polymerase chain reaction (PCR). Although HHV-6B DNA was detected at least once in about half of the patients; the other viruses were seldom detected. There was no association between HHV-6B detection and individual acute clinical events, however, HHV-6B detection was more common in children who experienced more frequent acute clinical events. In children being treated for various malignancies, HHV-6B detection was common, but was not associated with individual events of acute illness. Thus, if HHV-6B is not assessed longitudinally, clinical events may be misattributed to the virus. The elevated frequency of detection of HHV-6B in sicker children is consistent with prior reports of its detection during apparently unrelated acute clinical events. J. Med. Virol. 88:1427-1437, 2016. © 2016 Wiley Periodicals, Inc.
Subject(s)
Drug-Related Side Effects and Adverse Reactions/virology , Herpesvirus 6, Human/isolation & purification , Neoplasms/complications , Neoplasms/drug therapy , Roseolovirus Infections/virology , Acute Disease , Adolescent , Adult , Child , Child, Preschool , Cohort Studies , DNA, Viral/blood , Drug Therapy , Female , Herpesvirus 6, Human/genetics , Herpesvirus 7, Human/genetics , Herpesvirus 7, Human/isolation & purification , Humans , Infant , Longitudinal Studies , Male , Neoplasms/virology , Polymerase Chain Reaction , Roseolovirus Infections/diagnosis , Roseolovirus Infections/etiology , Viral Load , Young AdultABSTRACT
We conducted a cross-sectional study of beta-herpesviruses in febrile pediatric oncology patients (n = 30), with a reference group of febrile pediatric solid-organ transplant recipients (n = 9). One (3.3%) of 30 cancer patients and 3 (33%) of 9 organ recipients were PCR positive for cytomegalovirus. Four (13%) of 30 cancer patients and 3 (33%) of 9 transplant recipients had human herpesvirus 6B (HHV-6B) DNAemia, which was more common within 6 months of initiation of immune suppression (4 of 16 vs. 0 of 14 cancer patients; p = 0.050). HHV-6A and HHV-7 were not detected. No other cause was identified in children with HHV-6B or cytomegalovirus DNAemia. One HHV-6B-positive cancer patient had febrile disease with concomitant hepatitis. Other HHV-6B-positive children had mild "viral" illnesses, as did a child with primary cytomegalovirus infection. Cytomegalovirus and HHV-6B should be included in the differential diagnosis of febrile disease in children with cancer.
Subject(s)
Betaherpesvirinae/isolation & purification , Herpesviridae Infections/complications , Herpesviridae Infections/virology , Immunocompromised Host , Neoplasms/complications , Adolescent , Adult , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Organ Transplantation/adverse effects , Viremia/complications , Viremia/virologyABSTRACT
Community-associated strains of methicillin-resistant Staphylococcus aureus (CA-MRSA) have recently emerged as a major cause of serious infections among older children and are now being seen in NICU patients. We present the case of a preterm infant with CA-MRSA necrotizing pneumonia and secondary bacteremia.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/diagnosis , Bacteremia/drug therapy , Methicillin Resistance , Pneumonia, Staphylococcal/diagnosis , Pneumonia, Staphylococcal/drug therapy , Staphylococcus aureus/drug effects , Antitubercular Agents/therapeutic use , Bacteremia/microbiology , Community-Acquired Infections/diagnosis , Community-Acquired Infections/drug therapy , Drug Administration Schedule , Gentamicins/therapeutic use , Humans , Infant, Newborn , Necrosis , Rifampin/therapeutic use , Twins , Vancomycin/therapeutic useABSTRACT
Pseudomonas stutzeri is a rare cause of nosocomial infection. We report a pediatric case of nosocomially acquired P. stutzeri brain abscess after subdural grid implantation before surgery for refractory epilepsy and review the literature.
