1. Community acquired respiratory virus infections in cancer patients-Guideline on diagnosis and management by the Infectious Diseases Working Party of the German Society for haematology and Medical Oncology.
- Author
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von Lilienfeld-Toal M, Berger A, Christopeit M, Hentrich M, Heussel CP, Kalkreuth J, Klein M, Kochanek M, Penack O, Hauf E, Rieger C, Silling G, Vehreschild M, Weber T, Wolf HH, Lehners N, Schalk E, and Mayer K
- Subjects
- Adenovirus Infections, Human diagnosis, Adenovirus Infections, Human epidemiology, Adenovirus Infections, Human therapy, Cidofovir, Community-Acquired Infections diagnosis, Community-Acquired Infections epidemiology, Cytosine analogs & derivatives, Cytosine therapeutic use, Germany, Hand Hygiene, Humans, Influenza, Human diagnosis, Influenza, Human epidemiology, Influenza, Human therapy, Lung diagnostic imaging, Masks, Medical Oncology, Metapneumovirus, Neuraminidase antagonists & inhibitors, Nucleic Acid Amplification Techniques, Organophosphonates therapeutic use, Oseltamivir therapeutic use, Paramyxoviridae Infections diagnosis, Paramyxoviridae Infections epidemiology, Paramyxoviridae Infections therapy, Patient Isolation, Pneumonia, Viral diagnosis, Pneumonia, Viral epidemiology, Pneumonia, Viral therapy, Respiratory Syncytial Virus Infections diagnosis, Respiratory Syncytial Virus Infections epidemiology, Respiratory Syncytial Virus Infections therapy, Respiratory Tract Infections diagnosis, Respiratory Tract Infections epidemiology, Ribavirin therapeutic use, Tomography, X-Ray Computed, Virus Diseases diagnosis, Virus Diseases epidemiology, Antiviral Agents therapeutic use, Community-Acquired Infections therapy, Immunoglobulins, Intravenous therapeutic use, Immunologic Factors therapeutic use, Neoplasms epidemiology, Respiratory Tract Infections therapy, Virus Diseases therapy
- Abstract
Background: Community acquired viruses (CRVs) may cause severe disease in cancer patients. Thus, efforts should be made to diagnose CRV rapidly and manage CRV infections accordingly., Methods: A panel of 18 clinicians from the Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology have convened to assess the available literature and provide recommendations on the management of CRV infections including influenza, respiratory syncytial virus, parainfluenza virus, human metapneumovirus and adenovirus., Results: CRV infections in cancer patients may lead to pneumonia in approximately 30% of the cases, with an associated mortality of around 25%. For diagnosis of a CRV infection, combined nasal/throat swabs or washes/aspirates give the best results and nucleic acid amplification based-techniques (NAT) should be used to detect the pathogen. Hand hygiene, contact isolation and face masks have been shown to be of benefit as general infection management. Causal treatment can be given for influenza, using a neuraminidase inhibitor, and respiratory syncytial virus, using ribavirin in addition to intravenous immunoglobulins. Ribavirin has also been used to treat parainfluenza virus and human metapneumovirus, but data are inconclusive in this setting. Cidofovir is used to treat adenovirus pneumonitis., Conclusions: CRV infections may pose a vital threat to patients with underlying malignancy. This guideline provides information on diagnosis and treatment to improve the outcome., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2016
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