• Angela P Campbell, Jason W Chien, Jane Kuypers, Janet A Englund, Anna Wald, Katherine A Guthrie, Lawrence Corey, and Michael Boeckh.
• Department of Pediatrics, University of Washington, Seattle, Washington, USA. angela.campbell@seattlechildrens.org
• J. Infect. Dis. 2010 May 1; 201 (9): 1404-13.

BackgroundFew data exist on respiratory virus quantitation in lower respiratory samples and detection in serum from hematopoietic cell transplant (HCT) recipients with respiratory virus-associated pneumonia.MethodsWe retrospectively identified HCT recipients with respiratory syncytial virus (RSV), parainfluenza virus, influenza virus, metapneumovirus (MPV), and coronavirus (CoV) detected in bronchoalveolar lavage (BAL) samples, and we tested stored BAL and/or serum samples by quantitative polymerase chain reaction.ResultsIn 85 BAL samples from 82 patients, median viral loads were as follows: for RSV (n = 35), 2.6 x 10(6) copies/mL; for parainfluenza virus (n = 35), 4.9 x 10(7) copies/mL; for influenza virus (n = 9), 6.8 x 10(5) copies/mL; for MPV (n = 7), 3.9 x 10(7) copies/mL; and for CoV (n = 4), 1.8 x 10(5) copies/mL. Quantitative viral load was not associated with mechanical ventilation or death. Viral RNA was detected in serum samples from 6 of 66 patients: 4 of 41 with RSV pneumonia, 1 with influenza B, and 1 with MPV/influenza A virus/CoV coinfection (influenza A virus and MPV RNA detected). RSV detection in serum was associated with high viral load in BAL samples (p = .05), and viral RNA detection in serum was significantly associated with death (adjusted rate ratio, 1.8; (p = .02).ConclusionQuantitative polymerase chain reaction detects high viral loads in BAL samples from HCT recipients with respiratory virus pneumonia. Viral RNA is also detectable in the serum of patients with RSV, influenza, and MPV pneumonia and may correlate with the severity of disease.

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