Presumed respiratory syncytial virus pneumonia in three immunocompromised adults

Three cases of presumed respiratory syncytial virus (RSV) pneumonia in immunocompromised adults are described. Two patients had symptoms of cough, fever, and malaise, following completion of a course of combination chemotherapy for the treatment of acute lymphoblastic leukemia. The third patient, a juvenile onset diabetic, developed similar symptoms while hospitalized for severe hyperglycemia. Chest roentgenograms showed lower lobe infiltrates in both leukemic patients and a bilateral non-confluent bronchopneumonia in the diabetic patient. All patients had a marked rise in complement-fixing antibody titres to RSV, suggesting a concurrent infection with the virus. Extensive microbiological investigations failed to reveal any other etiologic agent. Nosocomial infection was considered possible. RSV is not considered a cause of pneumonia in compromised adults. Our three cases suggest that there may be a higher incidence of RSV pneumonia in compromised patients, than previously recognized.