Assuntos
Anticorpos Antivirais/sangue , Metapneumovirus/imunologia , Infecções por Paramyxoviridae/fisiopatologia , Infecções por Vírus Respiratório Sincicial/fisiopatologia , Vírus Sincicial Respiratório Humano/imunologia , Infecções Respiratórias/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Infecções por Paramyxoviridae/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologiaRESUMO
Human metapneumovirus (hMPV) was newly discovered as a pathogen in 2001 and is thought to be associated with respiratory disease. To elucidate the prevalence and clinical significance of hMPV among children, we investigated the positive cases of hMPV-RNA by reverse transcription-polymerase chain reaction (RT-PCR) in their nasopharyngeal specimens collected from January to August 2003 in Hiroshima Prefecture, Japan. Our prospective study revealed 77 hMPV-positive cases among 377 children with acute respiratory diseases. Clinical diagnoses of 77 hMPV-positive cases were as follows; bronchitis (33.8%), pneumonia (24.7%), acute respiratory illness (19.5%), asthmatic bronchitis (11.7%) and bronchiolitis (5.2%). The most common symptoms were cough (97.4%), high fever (94.8%) and rhinorrhea (76.6%). Most of the hMPV-positive cases were identified in the spring (between March and May), indicating the presence of an epidemic of hMPV infection in Hiroshima Prefecture. Phylogenetic analysis of the amplified F gene of hMPV isolates revealed that hMPV strains were divided into two genotypes and that their simultaneous circulation occurred within the same epidemic area of Hiroshima Prefecture.
Assuntos
Surtos de Doenças , Metapneumovirus , Infecções por Paramyxoviridae/epidemiologia , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Prevalência , Estudos ProspectivosRESUMO
An 11-year-old boy had intermittent fever and hepatosplenomegaly. The diagnosis of chronic active Epstein-Barr virus (EBV) infection was established from an abnormal pattern of anti-EBV antibody; EBV was detected in bone marrow cells. Immunochemotherapy alleviated the patient's symptoms. However, when a subsequent oral prednisolone dose was tapered, heart failure ensued and he died. Autopsy findings demonstrated that myocarditis resulted from infiltrating T lymphocytes with the EBV genome and a benign histologic appearance. A clonality study of T lymphocytes indicated no such evidence of monoclonality. EBV-infected T cells play an important role in the pathogenesis of myocarditis in chronic active EBV infection.