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.
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.
CRV infections may pose a vital threat to patients with underlying malignancy. This guideline provides information on diagnosis and treatment to improve the outcome.
来自德国血液学和肿瘤医学学会传染病工作组的18名临床医生组成的小组召开会议,评估现有文献,并就包括流感在内的CRV感染的管理提供建议。呼吸道合胞病毒,副流感病毒,人偏肺病毒和腺病毒。
癌症患者的CRV感染可能导致大约30%的病例出现肺炎,相关死亡率约为25%。对于CRV感染的诊断,联合鼻/喉拭子或洗液/吸液可获得最佳结果,应使用基于核酸扩增的技术(NAT)检测病原体。手部卫生,接触隔离和口罩已被证明是有益的一般感染管理。流感可以给予因果治疗,使用神经氨酸酶抑制剂,和呼吸道合胞病毒,使用利巴韦林除了静脉注射免疫球蛋白。利巴韦林也被用于治疗副流感病毒和人偏肺病毒,但是在这种情况下,数据还没有定论。西多福韦用于治疗腺病毒肺炎。
CRV感染可能对潜在恶性肿瘤患者构成严重威胁。该指南提供了有关诊断和治疗的信息,以改善预后。