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Volume 14, Number 4—April 2008

CME ACTIVITY

β-Herpesviruses in Febrile Children with Cancer

Stephanie Yee-Guardino*, Kate Gowans*, Belinda Yen-Lieberman†, Pamela Berk†, Debra Kohn†, Fu-Zhang Wang†1, Lara Danziger-Isakov*†, Camille Sabella*†, Sarah Worley†, Philip E. Pellett†2Comments to Author , and Johanna Goldfarb*†
Author affiliations: *Cleveland Clinic Children’s Hospital, Cleveland, Ohio, USA; †Cleveland Clinic, Cleveland, Ohio, USA; 1Current affiliation: University of North Carolina, Chapel Hill, North Carolina, USA; 2Current affiliation: Wayne State University School of Medicine, Detroit, Michigan, USA;

Main Article

Table 1

Characteristics of febrile immune-suppressed children*

Characteristic Cancer
(n = 30) SOT
(n = 9)
Age, y; mean, median, range
6.1, 5.0, 
0.4–17
11.8, 13.3, 4.3–20.6
Sex
F 14 7
M
16
2
Basis of immune suppression
Cancer 30 (77%)
Solid tumor 20
Leukemia 9
Lymphoma 1
Solid-organ transplant 9 (23%)
Heart 5
Lung 2
Liver

2
Immune suppressants 29 9
Cytotoxic chemotherapy 28
Radiation 6
Chemotherapy and radiation 6
Immune modulators† 9
Steroids (past 6 months)
14
7
Signs and symptoms
Ill appearance 7 1
Upper respiratory 17 1
Gastrointestinal 10 7
Headache 3 3
Rash 0 0
Seizure 0 0
Hepatitis
1
1
Blood products (past 6 months)‡ 20 5
Laboratory parameters
Neutropenic (<500 cells/μL) 14 2
Lymphopenic (<500 cells/μL)
13
4
Established source for fever
Bacteremia 2 0
Positive respiratory DFA test 
 result§ 3 2

*SOT, solid-organ transplantation; –, not applicable; DFA, direct fluorescence antigen.
†Immune modulators included tacrolimus in 4, tacrolimus and azathioprine in 2, cyclosporine and mycophenolate mofetil in 2, sirolimus in 1, and tacrolimus, mycophenolate mofetil, antithymocyte globulin (rabbit), and corticosteroids in 1.
‡Blood products recorded included packed erythrocytes or platelets.
§Of the 5 patients with positive respiratory DFA test results, 2 were positive for parainfluenza 3, 2 for influenza A, and 1 for respiratory syncytial virus.

Main Article

1Current affiliation: University of North Carolina, Chapel Hill, North Carolina, USA

2Current affiliation: Wayne State University School of Medicine, Detroit, Michigan, USA

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