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[Human Metapneumovirus in hospitalized children - a review]
A Wilkesmann1, O Schildgen, A M Eis-Hübinger
1Zentrum für Kinderheilkunde am Universitätsklinikum Bonn.
Abstract:
The human Metapneumovirus (HMPV) has been discovered by von den Hoogen et al. in 2001 and seems to play an important role as etiologic agent in childhood respiratory tract infections in particular involving infants after the 6th month of life and toddlers. Duly considering the hitherto published studies and retrospective analysis of two HMPV seasons (2002-2004) at our institution this review focuses on children, who had to be hospitalized due to HMPV infection. The analysis confirmed, that among those patients there is a high proportion of children with pre-existing risk factors for a complicated clinical course, a high proportion of children with bronchiolitis or pneumonia and a relevant proportion of children with HMPV related apnoeas, most prevalent in the prematurely born. Although the first HMPV infection takes place somewhat later in infancy, the data do not show that HMPV infection is in general milder than RSV infection in hospitalized children. Clinical symptoms and radiological signs do not permit tentative conclusions on the causative agent. This underlines the necessity of specific diagnostic efforts (in case of HMPV with PCR). HMPV may cause lobar or segmental pneumonias difficult to distinguish from bacterial lower respiratory tract infection. Children admitted to the hospital with an acute exacerbation of asthma bronchiale or cystic fibrosis should not only be tested for RSV but also for HMPV. Prospective studies investigating specific therapeutic interventions or describing the impact and prevention of nosocomial HMPV in fection are awaited for. There has been one report of a meningoencephalitis possibly related to HMPV. Thus, liquor samples in such cases should be tested for HMPV too.
Insights
Human Metapneumovirus (HMPV) is a significant cause of severe respiratory infections in young children, often requiring hospitalization. HMPV infections can present with pneumonia, apnea, and mimic bacterial infections, necessitating specific diagnostic tests.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Respiratory Medicine
Context:
- Human Metapneumovirus (HMPV), identified in 2001, is a key etiological agent of childhood respiratory infections.
- This review analyzes hospitalized children with HMPV infections from two seasons (2002-2004).
Purpose:
- To highlight the clinical characteristics and risk factors associated with severe HMPV infections in hospitalized children.
- To emphasize the diagnostic challenges and the need for specific testing for HMPV.
Summary:
- Hospitalized children with HMPV often have pre-existing risk factors, leading to severe outcomes like bronchiolitis, pneumonia, and apnea, particularly in premature infants.
- HMPV infections can manifest as lobar or segmental pneumonias, indistinguishable from bacterial infections, and may rarely be associated with meningoencephalitis.
- Clinical presentation and radiological findings are insufficient for definitive diagnosis, underscoring the importance of PCR testing for HMPV.
Impact:
- Informs clinicians about the significant role of HMPV in pediatric respiratory illness, especially in vulnerable populations.
- Stresses the need for HMPV testing in hospitalized children with respiratory symptoms, including those with asthma or cystic fibrosis exacerbations.
- Highlights the necessity for further research into HMPV-specific therapies and the prevention of hospital-acquired HMPV infections.
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