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Incidence of Viremia With DNA Viruses in Oncology Patients With Febrile Neutropenia

Teranishi, Hideto, MD, PhD; Ohzono, Nanae, RA; Miyata, Ippei, MD, PhD; Wakabayashi, Shoko, MD; Kono, Mina, MD; Ono, Sahoko, MD; Kato, Atsushi, MD; Saito, Aki, MD; Kondo, Eisuke, MD; Tanaka, Yuuhei, MD, PhD; Akaike, Hiroto, MD, PhD; Oishi, Tomohiro, MD, PhD; Ohno, Naoki, MD, PhD; Terada, Kihei, MD, PhD; Ouchi, Kazunobu, MD, PhD

Journal of Pediatric Hematology/Oncology: November 2018 - Volume 40 - Issue 8 - p 605–608
doi: 10.1097/MPH.0000000000001300
Original Articles

Background: Although febrile neutropenia (FN) is one of the most common adverse events produced by chemotherapy, its microbiological etiology is determined for only 15% to 30% of cases.

Objectives: We investigated the rate of viremia with common DNA viruses in patients with FN.

Study Design: From June 2012 to April 2014, 72 blood samples from 24 patients receiving chemotherapy, who experienced FN episodes, were examined for the presence of herpes viruses and other DNA viruses. We used real-time polymerase chain reaction assays to detect herpes simplex virus type 1 and 2, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, human herpes virus types 6 and 7, BK virus and human parvovirus B19 (B19).

Results: Viruses were identified in 14 of 72 samples (19.4%). The detected etiological agents were BK virus (5 episodes), human herpes virus type 6 (4 episodes), B19 (4 episodes), Epstein-Barr virus (2 episodes), and cytomegalovirus (1 episode).

Conclusions: Our results indicate that viral infections are common causes in patients with FN. Therefore, viruses may be responsible for FN in a large proportion of patients in whom a causative microorganism could not be identified, and this viral etiology may explain their poor response to antibiotic therapy.

Department of Pediatrics, Kawasaki Medical School, Kurashiki, Japan

H.T.: contributed substantially to the conception and design of the study, the acquisition of data, or the analysis and interpretation. N.O.: contributed to the analysis and interpretation. I.M.: contributed to the conception and design of the study. S.W., M.K., S.O., A.K., A.S., E.K., Y.T., H.A., T.O., N.O., and K.T.: contributed to the acquisition of data. K.O. contributed substantially to the conception and design of the study.

Supported by annual grants to the authors from Kawasaki Medical School, and Research Project Grant for this research (24G1) from Kawasaki Medical School.

The authors declare no conflict of interest.

Reprints: Hideto Teranishi, MD, PhD, Department of Pediatrics, Kawasaki Medical, School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan (e-mail:

Received December 12, 2017

Accepted July 24, 2018

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