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:

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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:

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Clinical Presentation

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

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Treatment

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

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Prognosis

• 83% mortality in leukemia-related cases

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References

• xxx