Respiratory Tract Infections Due to Human Metapneumovirus in Immunocompromised Children

Chu, Helen Y.; Renaud, Christian; Ficken, Elle; Thomson, Blythe; Kuypers, Jane; Englund, Janet A.

Nine (16%) patients were HSCT recipients; indications for transplant included aplastic anemia (n = 4, 44%), SCID (n = 2, 22%), Ewing sarcoma (n = 1, 11%), acute lymphoblastic leukemia (ALL) (n = 1, 11%), and osteopetrosis (n = 1, 11%). In this subset, 4 (50%) had abnormal chest imaging, and 1 (11%) required supplemental oxygen. The chest radiograph and computed tomography imaging of 3 representative patients are illustrated in Figure 1 (Patients 1, 2, and 3). Three (33%) of these patients had a diagnosis of hMPV prior to transplant, including 2 children with SCID and 1 with aplastic anemia. In general, the policy at our institution is to delay transplant if patients have respiratory tract infections; however, in these 3 cases, it was felt that due to their underlying disease and lack of functioning immune system, these patients would not be able to clear their viral infection without HSCT. Two of these transplant recipients subsequently died due to hMPV infection.