ROLE OF RESPIRATORY VIRUSES IN THE ETIOLOGY OF FEVER (F+) OCCURRING DURING CHEMOTHERAPY-INDUCED GRANULOCYOPENIA(G+):

Nearly half of the fevers (>38.0°C) occurring during chemotherapy-induced G+ do not have a defined bacterial origin. We investigated whether respiratory viruses might account for some of these F+ episodes either as the primary cause of F+, as a coinfection, or an antecedent infection. During an 11 month period, throat washings obtained from 60 F+G+ adult and pediatric cancer patients were assayed for common respiratory viruses by enzyme-linked immunoassay. Positive viral washings were found in 25% of patients (15% influenza, 8% adenovirus, 2% parainfluenza). Patients with positive viral washings could not be distinguished on the basis of presenting symptoms, initial chest x-ray findings, height of initial F+, duration of F+, initial neutrophil count, or duration of G+. A bacterial infection was diagnosed in 15 of 44 patients with negative viral washings and 1 of 15 with positive viral washings. Respiratory viruses were not infrequently identified in patients with F+G+. Although the relatively small number of episodes studied precludes a definitive conclusion, respiratory virus infection does not appear to be implicated as an antecedent event for bacterial infection in F+G+ episodes and may be a primary cause of fever in this patient population. This study is continuing.