Table 3.
Clinical Manifestation of Transplant Recipients With Bocavirus Detected in Lower Respiratory Tract Samples (Retrospective Cohort)
| Case | 1 | 2 | 3 | 4 | 5 | 6 |
|---|---|---|---|---|---|---|
| Year | 2008 | 2011 | 2015 | 2018 | 1993 | 1993 |
| Age, y | 64 | 1 | 20 | 23 | 11 | 52 |
| Gender | Male | Female | Male | Male | Female | Male |
| Underlying disorder | Lymphoma | Hemophagocytic lymphohistiocytosis | Acute lymphoblastic leukemia | Acute myeloid leukemia | Acute lymphoblastic leukemia | Chronic myeloid leukemia |
| Donor type | Matched/unrelated | Matched/unrelated | Cord/unrelated | Matched/unrelated | Matched/unrelated | Matched/related |
| Donor source | PBSC | BM | Cord blood | PBSC | BM | BM |
| Immunosuppressant before LRTI | FK | FK, MTX, steroid 0.9 mg/kg | FK, steroid 0.9 mg/kg | FK, cytarabine, steroid 0.5 mg/kg | CyA, steroid 1 mg/kg | CyA, steroid > 1 mg/kg |
| Days of LRTI diagnosis (posttransplant) | 231 | 18 | 106 | 805 | 126 | 78 |
| Preceding BoV detection in nose | 69 days before LRTI | 16 days before LRTI | ||||
| Findings in chest imaging | Pleural effusion, tree in bud opacities | Atelectasis | Patchy GGO, nodules | GGO, centrilobular nodules, mycetoma | Pleural effusion, consolidation | Pulmonary nodules |
| Ct values of BoV in initial and subsequent BALs | Unknown | Unknown → not detected (4 days after) | 29.5 → 32.6 (11 days after) | 35.4 (lung autopsy) | 26.4 → 20.3 (6 days after) | 16.9 → 31 (11 days after) |
| Copathogens in BALs | HRV | AdV, HRV | None | Fusarium, Aspergillus fumigatus (lung autopsy) | KI polyomavirus | Aspergillus fumigatus grew from sputum culture |
| Respiratory support following LRTI diagnosis | Supplemental oxygen | Mechanical ventilator (airway protection) | Mechanical ventilator | Supplemental oxygen | Supplemental oxygen | Supplemental oxygen |
| Concomitant illness | Rib fracture, fluid overload, aspiration | Bleeding from mucositis, fluid overload | Diffuse alveolar hemorrhage | Septic shock, relapse, GVHD | None | None |
| Clinical diagnosis at death (within 90 d after LRTI) | N/A | N/A | MOF, respiratory failure (29 days after) | MOF, respiratory failure (same day) | Arrest, seizure (47 days after) | Sepsis (resistant enterococcus), respiratory failure (23 days after) |
Abbreviations: AdV, adenovirus; BAL, bronchoalveolar lavage; BM, bone marrow; BoV, human bocavirus; Ct, cycle threshold; CyA, cyclosporine; FK, tacrolimus; GGO, ground glass opacities; HRV, human rhinovirus; LRTI, lower respiratory tract infection; MOF, multiorgan failure; MTX, methotrexate; N/A, not applicable; PBSC, peripheral blood stem cell.