Rhinovirus infections in myelosuppressed adult blood and marrow transplantrecipients

Scant data are available on the clinical significance of rhinovirus infecti ons in immunocompromised patients. We reviewed the clinical courses of and outcomes for 22 myelosuppressed adult blood and marrow transplant recipient s with rhinovirus infections who were hospitalized at the M, D. Anderson Ca ncer Center (Houston) from January 1992 to January 1997. In 15 patients (68 %), illnesses remained confined to the upper respiratory tract. Seven patie nts (32%) developed fatal pneumonia. These patients had profound respirator y failure a mean of 12 days (range, 3-21 days) after the onset of symptoms. In six of these seven cases, rhinovirus was isolated before death from a b ronchoalveolar lavage fluid specimen and/or an endotracheal aspirate. Five patients underwent autopsies, one of which revealed disseminated aspergillo sis and four of which revealed interstitial pneumonitis and/or acute respir atory distress syndrome and no other organisms. In conclusion, rhinovirus i nfections may be associated with considerable pulmonary-related morbidity a nd mortality in severely myelosuppressed immunocompromised patients.