Volume 14, Number 4—April 2008
CME ACTIVITY - Research
β-Herpesviruses in Febrile Children with Cancer
, and Johanna Goldfarb*†
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.
1Current affiliation: University of North Carolina, Chapel Hill, North Carolina, USA
2Current affiliation: Wayne State University School of Medicine, Detroit, Michigan, USA