Table 3. Clinical features and pathogens defining the presence of a viral OI.
| Viruses | Clinical Condition |
|---|---|
| Cytomegalovirus (CMV) [13, 14, 16, 23, 28, 29] | Cytomegalovirus disease onset at age > 1 month: pneumonia (CMV-DNA in bronchoalveolar lavage), colitis, central nervous system disease (CMV in cerebrospinal fluid), liver, retinitis (confirmed by an ophthalmologist), nephritis, myocarditis, pancreatitis other. In all cases, typical histological lesions and histopathological detection of the virus must be present. A positive PCR on tissue specimens is not sufficient for the diagnosis (exceptions are shown in parenthesis). |
| EBV [30-32] | EBV-induced fulminant infectious mononucleosis with the presence of diffuse lymphadenopathy, hepatosplenomegaly and extensive tissue damage – especially liver and bone marrow - encephalitis and haemophagocytic-lympho-histiocytosis, B-cell lymphoma and dysgammaglobulinaemia. Chronic active EBV infection: persistent or recurrent infectious mononucleosis-like syndrome with additional complications including hematological, digestive tract, neurological, pulmonary, ocular, dermal, and/or cardiovascular disorders (comprising aneurysm and valvular disease), with very high viral load (> 102.5 copies/microgr DNA). |
| Hepatitis B Virus [15, 19, 33] | Reactivation |
| Hepatitis C Virus [15, 19, 33] | Reactivation/progression |
| Hepatitis E Virus [34] | Chronic hepatitis |
| HSV [15, 16, 19] | Herpes simplex: chronic ulcers (orolabial or cutaneous or genital > 1 month duration) or bronchitis, pneumonitis or esophagitis, encephalitis or other visceral involvement (onset at age > 1 month). |
| VZV [15, 16, 19, 35] | Varicella with systemic involvement (onset at age > 1 month): neurologic manifestations (encephalitis, ataxia transverse myelitis), hepatitis, pneumonia, multi-organ failure with disseminated intravascular coagulation. Persistent chronic infection: appearance of new lesions for a period > 1 month after primary or recurrent infection, evolving in non-healing ulcers or necrotic, crusted and hyperkeratotic, verrucous lesions. Herpes zoster: uncomplicated herpes zoster: vesicles limited to no more than 3 dermatomers; disseminated or invasive: cutaneous lesion in > 3 dermatomers (disseminated cutaneous) and/or evidence of deep organ involvement. |
| Adenovirus [15, 16, 19, 36, 37] | Disseminated disease: hepatitis, hemorrhagic cystitis, persistent gastroenteritis. |
| Influenza [15, 16, 19] | Pneumonia, encephalitis. |
| RSV [15, 16, 19] | Pneumonia (with onset at age > 6 months). |
| Viruses | Clinical Condition |
| hMPV [15, 16, 19] | Pneumonia, acute respiratory distress syndrome. |
| HHV6, HHV7 [15, 16, 19, 38] | Pneumonia, encephalitis. |
| HHV8 [15, 16, 19, 39] | Kaposi sarcoma. |
| Parvovirus B19 [15, 16, 19] | Chronic/persistent pure red cell aplasia. |
| Rotavirus, Norovirus [15, 16, 19, 40] | Chronic (>1 month duration) diarrhea. |
| JC virus [15, 16, 19] | Progressive multifocal encephalopathy. |
| Molluscum contagiosum virus (poxvirus) [41] | Chronic molluscum contagiosus. |
| BK virus [15, 16, 19, 40] | Polyomavirus nephropathy (PVAN), hemorrhagic cystitis. |
| HPV [15, 16, 19] | Disseminated warts. |
| Enterovirus [14] | Chronic encephalitis. |
| West Nile, Usutu, Chikungunya, O’nyong nyong virus [16, 42, 43] | Encephalitis. |