Respiratory Syncytial Virus (RSV)

Epidemiology

  • Common in first few years of life (may cause tracheobronchitis/ pneumonia/ bronchiolitis)
  • High-risk adults (most cases are self-limited but immunocompromised may develop pneumonia/ ARDS):
    • Post-BMT: most commonly reported adult group
    • Leukemics: especially im cases with severe chemo-induced myelosuppression
    • Elderly:
    • Institutionalized:
    • Other immunocompromised:

Diagnosis

  • Sputum GS/Cult+Sens:
  • FOB:
    • BAL: viral culture is positive/ ELISA or IF viral antigen tests are positive
    • TBB: syncytial cells or viral cytoplasmic inclusions/ immunohisto-chemical stains with monoclonal Ab’s
  • CXR/Chest CT Patterns
    • Diffuse alveolar infiltrates:

Clinical Presentation

  • Pneumonia (see [[Pneumonia]])
    • Dyspnea
    • Cough
  • Pleural Effusion (see [[Pleural Effusion-Exudate]])
  • [[Acute Lung Injury-ARDS]]

Treatment

  • Aerosolized Ribavirin + IVIG:
    • No human clinical studies support this
    • Animal studies support use of IVIG
  • Infection control: contact precautions

Prognosis

  • 83% mortality in leukemia-related cases

References

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