Pediatric Human Metapneumovirus Workup

  • Author: Joseph Domachowske, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Oct 24, 2011
 

Laboratory Studies

  • A general respiratory virus culture obtained by nasal wash or nasopharyngeal swab should be performed in patients with clinical symptoms of lower respiratory tract viral infections.
  • Human metapneumovirus (hMPV) has proven to be difficult to identify using common clinical virologic procedures. Human metapneumovirus replicates slowly in primary cynomolgus monkey kidney cells and poorly in Vero cells and A549 cells (a human respiratory epithelial cell line). Other cell lines commonly used in viral diagnostic laboratories do not appear to support the replication of human metapneumovirus.
  • Commercial reagents to confirm the presence of human metapneumovirus infection are available. Detection techniques that have been developed include virus identification by reverse transcriptase-polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA), and the rapid culture technique known as shell vial amplification. The clinical sample appropriate for submission to the laboratory may include nasal wash or aspirate fluid, nasopharyngeal flock swab culture, endotracheal tube aspirate, and/or bronchoalveolar lavage fluid.[9] To determine the optimal biologic sample, consult directly with the local clinical virology team because the best sample types vary according to the specific tests offered.
  • Further diagnostic evaluation, including a CBC count and a blood culture, may be necessary to exclude invasive bacterial disease.
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Imaging Studies

  • Chest radiography is appropriate in patients who present with symptoms of lower respiratory tract disease.
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Histologic Findings

  • Currently, histologic findings are unknown.
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Contributor Information and Disclosures
Author

Joseph Domachowske, MD  Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University

Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Itzhak Brook, MD, MSc  Professor, Department of Pediatrics, Georgetown University School of Medicine

Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Armed Forces Infectious Diseases Society, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Ear, Nose and Throat Advances in Children, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, and Surgical Infection Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Leslie L Barton, MD  Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

References

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  16. Robinson JL, Lee BE, Bastien N, Li Y. Seasonality and clinical features of human metapneumovirus infection in children in Northern Alberta. J Med Virol. 2005;76:98-105. [Medline].

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Phylogenetic tree showing sequence analysis of human metapneumovirus (HMPV).
 
 
 
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