The Turkish Journal of Pediatrics 2017 , Vol 59 , Num 5
Effects of respiratory viruses on febrile neutropenia attacks in children
Bilge Aldemir-Kocabaş 1 ,Adem Karbuz 1 ,Esra Pekpak 2 ,Zeynep Ceren Karahan 3 ,İştar Dolapçı 3 ,Elif İnce 2 ,Zümrüt Uysal 2 ,Gülsan Yavuz 4 ,Ergin Çiftçi 1 ,Erdal İnce 1
1 Departments of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
2 Departments of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
3 Departments of Medical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
4 Departments of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
DOI : 10.24953/turkjped.2017.05.002 Aldemir-Kocabaş B, Karbuz A, Pekpak E, Karahan ZC, Dolapçı İ, İnce E, Uysal Z, Yavuz G, Çiftçi E, İnce E. Effects of respiratory viruses on febrile neutropenia attacks in children. Turk J Pediatr 2017; 59: 511-519.

Respiratory tract viruses have an important effect on morbidity and mortality in patients with febrile neutropenia (FN). The aim of this study was to determine frequency and clinical influence of viral respiratory viruses as potential etiologic agents in episodes of FN in children. A total of 100 children (62 boys, 38 girls) with 166 FN episodes were included in this prospective study. Nasopharyngeal aspirate samples were analyzed for respiratory viral agents using multiplex real-time polymerase chain reaction. The origin of the fever could be defined in 111 (67%) of the episodes. We detected viral agents in 86 (51.8%), bacterial agents in 19 (11.4%), and fungal agents in 5 (3%) of the episodes. The most common detected viruses were rhinovirus (n= 27), respiratory syncytial virus (n=17), and coronavirus (n=16). Parainfluenza virus, influenza A and B, adenovirus, human metapneumovirus, enterovirus, bocavirus and parechovirus were the remaining detected agents. More than one virus positivity occurred in 13 FN episodes. Forty-three patients had multiple FN episodes. Only four patients had the same viral agent in consecutive attacks. Respiratory symptoms (cough, nasal discharge and congestion, sneezing, wheezing), physical examination signs (rales and rhonchi) and radiological findings were significantly more common in viral agent positive patients (p < 0.05). This study showed that respiratory viruses make a substantial contribution on the etiology of FN episodes in children. Identifying viral agents may help to constitute individualized infection-management algorithms in these patients. Keywords : children, fever, neutropenia, respiratory virus

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