TY - JOUR
T1 - Detection of severe human metapneumovirus infection by real-time polymerase chain reaction and histopathological assessment
AU - Sumino, Kaharu C.
AU - Agapov, Eugene
AU - Pierce, Richard A.
AU - Trulock, Elbert P.
AU - Pfeifer, John D.
AU - Ritter, Jon H.
AU - Gaudreault-Keener, Monique
AU - Storch, Gregory A.
AU - Holtzman, Michael J.
N1 - Funding Information:
Received 9 December 2004; accepted 12 April 2005; electronically published 4 August 2005. Potential conflicts of interest: none reported. Financial support: National Institutes of Health Heart, Lung, and Blood Institute; Ruth Kopolow Gift Fund; Martin Schaeffer Fund; Alan A. and Edith L. Wolff Charitable Trust. Reprints or correspondence: Dr. Michael J. Holtzman, Washington University School of Medicine, Campus Box 8052, 660 S. Euclid Ave., St. Louis, MO 63110 ([email protected]).
PY - 2005/9/15
Y1 - 2005/9/15
N2 - Background. Infections with common respiratory tract viruses can cause high mortality, especially in immunocompromised hosts, but the impact of human metapneumovirus (hMPV) in this setting was previously unknown. Methods. We evaluated consecutive bronchoalveolar lavage and bronchial wash fluid samples from 688 patients-72% were immunocompromised and were predominantly lung transplant recipients-for hMPV by use of quantitative real-time polymerase chain reaction (PCR), and positive results were correlated with clinical outcome and results of viral cultures, in situ hybridization, and lung histopathological assessment. Results. Six cases of hMPV infection were identified, and they had a similar frequency and occurred in a similar age range as other paramyxoviral infections. Four of 6 infections occurred in immunocompromised patients. Infection was confirmed by in situ hybridization for the viral nucleocapsid gene. Histopathological assessment of lung tissue samples showed acute and organizing injury, and smudge cell formation was distinct from findings in infections with other paramyxoviruses. Each patient with high titers of hMPV exhibited a complicated clinical course requiring prolonged hospitalization. Conclusions. Our results provide in situ evidence of hMPV infection in humans and suggest that hMPV is a cause of clinically severe lower respiratory tract infection that can be detected during bronchoscopy by use of real-time PCR and routine histopathological assessment.
AB - Background. Infections with common respiratory tract viruses can cause high mortality, especially in immunocompromised hosts, but the impact of human metapneumovirus (hMPV) in this setting was previously unknown. Methods. We evaluated consecutive bronchoalveolar lavage and bronchial wash fluid samples from 688 patients-72% were immunocompromised and were predominantly lung transplant recipients-for hMPV by use of quantitative real-time polymerase chain reaction (PCR), and positive results were correlated with clinical outcome and results of viral cultures, in situ hybridization, and lung histopathological assessment. Results. Six cases of hMPV infection were identified, and they had a similar frequency and occurred in a similar age range as other paramyxoviral infections. Four of 6 infections occurred in immunocompromised patients. Infection was confirmed by in situ hybridization for the viral nucleocapsid gene. Histopathological assessment of lung tissue samples showed acute and organizing injury, and smudge cell formation was distinct from findings in infections with other paramyxoviruses. Each patient with high titers of hMPV exhibited a complicated clinical course requiring prolonged hospitalization. Conclusions. Our results provide in situ evidence of hMPV infection in humans and suggest that hMPV is a cause of clinically severe lower respiratory tract infection that can be detected during bronchoscopy by use of real-time PCR and routine histopathological assessment.
UR - http://www.scopus.com/inward/record.url?scp=24644433754&partnerID=8YFLogxK
U2 - 10.1086/432728
DO - 10.1086/432728
M3 - Article
C2 - 16107959
AN - SCOPUS:24644433754
SN - 0022-1899
VL - 192
SP - 1052
EP - 1060
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 6
ER -