Source:European Journal of Cancer, Volume 67
Author(s): Marie von Lilienfeld-Toal, Annemarie Berger, Maximilian Christopeit, Marcus Hentrich, Claus Peter Heussel, Jana Kalkreuth, Michael Klein, Matthias Kochanek, Olaf Penack, Elke Hauf, Christina Rieger, Gerda Silling, Maria Vehreschild, Thomas Weber, Hans-Heinrich Wolf, Nicola Lehners, Enrico Schalk, Karin Mayer
BackgroundCommunity acquired viruses (CRVs) may cause severe disease in cancer patients. Thus, efforts should be made to diagnose CRV rapidly and manage CRV infections accordingly.MethodsA 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.ResultsCRV 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.ConclusionsCRV infections may pose a vital threat to patients with underlying malignancy. This guideline provides information on diagnosis and treatment to improve the outcome.
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