Human metapneumovirus (HMPV) is a pathogen associated with respiratory tract infection and is related to avian pneumovirus. Typically, children, the elderly, and those who are immunocompromised are the most susceptible to HMPV infection; however, the virus can infect persons of all ages. In otherwise healthy individuals, HMPV infection is generally self-limiting, but immunocompromised individuals can develop fatal complications. We present a case series of 3 severely immunocompromised patients who were infected with HMPV and describe their clinical course. All 3 patients had acute myeloid leukemia, histories of neutropenic fever, and prolonged hospitalization stays. This case series highlights the severe sequelae observed in individuals infected with HMPV, particularly among those who are immunocompromised.
References
1.
van den HoogenB.G., de JongJ.C., GroenJ.A newly discovered human pneumovirus isolated from young children with respiratory tract disease.Nat Med.2001; 7(6): 719–724.
2.
FauquetC.M., MayoM.A., ManiloffJ., eds; Virology Division International Union of Microbiological Societies.Virus Taxonomy: Classification and Nomenclature of Viruses. Eighth Report of the International Committee on Taxonomy of Viruses.Oxford, UK: Elsevier Academic Press; 2005.
3.
KahnJ.S.Epidemiology of human metapneumovirus.Clin Microbiol Rev.2006; 19(3): 546–557.
4.
FalseyA.R., WalshE.E.Viral pneumonia in older adults.Clin Infect Dis.2006; 42(4): 518–524.
5.
BoivinG., MackayI., SlootsTP. Global genetic diversity of human metapneumovirus fusion gene.Emerg Infect Dis.2004; 10(6): 1154–1157.
6.
NjengaM.K., LwambaH.M., SealB.S.Metapneumovirus in birds and humans.Virus Res.2003; 91(2): 163–169.
WilliamsJ.V., WangC.K., YangCF. The role of hMPV in upper respiratory tract infections in children: a 20 year experience.J Infect Dis.2006; 193(3): 387–395.
11.
WilliamsJ.V., HarrisP.A., TollefsonS.J.Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children.N Engl J Med.2004; 350(5): 443–450.
12.
WilliamsJ.V.Human metapneumovirus: an important cause of respiratory disease in children and adults.Curr Infect Dis Rep.2005; 7(3): 204–210.
13.
van DijkN.M., LinssenC.F., BussinkM.Critical illness after horizontal nosocomial transmission of human metapneumovirus in the haemotology ward.Neth J Crit Care.2012; 16(1): 22–25. http://njcc.nl/sites/default/files/NJCC%2001%20casereport-vDijk.pdf. Accessed August 24, 2016.
14.
XepapadakiP., PsarrasS., BossiosA.Human metapneumovirus as a causative agent of acute bronchiolitis in infants.J Clin Virol.2004; 30(3): 267–270.
15.
Centers for Disease Control and Prevention. Outbreaks of human metapneumovirus in two skilled nursing facilities-West Virginia and Idaho, 2011-2012.MMWR Morb Mortal Wkly Rep.2013; 62(46): 909–913.
16.
CsekeG., MaginnisM.S., CoxR.G.Integrin alphabeta1 promotes infection by human metapneumovirus.Proc Natl Acad Sci USA.20093; 106(5): 1566–1571.
17.
HamelinM.E., CôtéS., LaforgeJ.Human metapneumovirus infection in adults with community acquired pneumonia and exacerbation of chronic obstructive pulmonary disease.Clin Infect Dis.2005; 41(4): 498–502.
18.
RenaudC., CampbellA.P.Changing epidemiology of respiratory viral infections in hematopoietic cell transplant recipients and solid organ transplant recipients.Curr Opin Infect Dis.2011; 24(4): 333–343.
19.
MilanoF., CampbellA.P., GuthrieK.A.Human rhinovirus and coronavirus detection among allogeneic hematopoietic stem cell transplantation recipients.Blood.2010; 115(10): 2088–2094.
20.
EnglundJ.A., BoeckhM., KuypersJ.Brief communication: fatal human metapneumovirus infection in stem cell transplant recipients.Ann Intern Med.2006; 144(5): 344–349.
21.
ChuH.Y., RenaudC., FickenE.Respiratory tract infections due to human metapneumovirus in immunocompromised children.J Pediatric Infect Dis Soc.2014; 3(4): 286–293.
22.
GodetC., Le GoffJ., Beby-DefauxA.Human metapneumovirus pneumonia in patients with hematological malignancies.J Clin Virol.2014; 61(4): 593–596.
23.
KambojM., GerbinM., HuangC.K.Clinical characterization of human metapneumovirus infection among patients with cancer.J Infect.2008; 57(6): 464–471.
24.
CôtéS., AbedY., BoivinG.Comparative evaluation of real-time PCR assays for detection of human metapneumovirus.J Clin Microbiol.2003; 41(8): 3631–3635.
25.
CaraccioloS., MinniC., ColombritaD.Human metapneumovirus infection in young children hospitalized with acute respiratory tract disease: virologic and clinical features.Pediatr Infect Dis J.2008; 27(5): 406–412.
26.
BuchholzU.J., NagashimaK., MurphyB.R.Live vaccines for human metapneumovirus designed by reverse genetics.Expert Rev Vaccines.2006; 5(5): 695–706.
27.
HirschH.H., MartinoR., WardK.N.Fourth European Conference on Infections in Leukaemia (ECIL-4): guidelines for diagnosis and treatment of human respiratory syncytial virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus.Clin Infect Dis.2013; 56(2): 258–266.
28.
HamelinM.E., PrinceG.A., BoivinG.Effect of ribavirin and glucocorticoid treatment in a mouse model of human metapneumovirus infection.Antimicrob Agents Chemother.2006; 50(2): 774–777.
29.
KitanovskiL., KoprivaS., PokornM.Treatment of severe human metapneumovirus pneumonia in an immunocompromised child with oral ribavirin and IVIG.J Pediatr Hematol Oncol.2013; 35(7): e311–e313.
