Journal Information
Vol. 35. Issue 3.
Pages 179-185 (January 2011)
Share
Share
Download PDF
More article options
Vol. 35. Issue 3.
Pages 179-185 (January 2011)
Full text access
Acute viral infections in immunocompetent patients
Infecciones virales graves en pacientes inmunocompetentes
Visits
1422
A. Díaza, R. Zaragozab,
Corresponding author
zaragozaraf@gva.es

Corresponding author.
, R. Granadac, M. Salavertd
a Servicio de Medicina Intensiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain
b Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain
c Servicio de Medicina Intensiva, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
d Unidad de Enfermedades Infecciosas, Hospital Universitario La Fe, Valencia, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Abstract

Viruses play a significant role in serious infections in adults and sometimes lead to the need for hospitalization and admission to intensive care units, especially in cases of severe respiratory distress or encephalopathy. Influenza and parainfluenza viruses, syncytial respiratory virus, herpes viruses and adenovirures are the most frequent causes of these severe infections. A review of the literature has been performed in order to update the epidemiology, pathogenesis and therapeutic approach of viral infections affecting immunocompetent patients. Furthermore, ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units and has a high morbidity and mortality rate. It is mainly a bacterial disease, although the potential role of viruses as pathogens or copathogens in VAP is under discussion. Therefore, a brief review of the potential pathogenic role of viruses in VAP has also been performed.

Keywords:
Viral infections
Immunocompetent
ARDS
Intensive Care Unit
Resumen

Los virus tienen un papel importante dentro de las infecciones graves en los pacientes adultos, que en algunas ocasiones llegan a necesitar hospitalización e ingreso en unidades de cuidados intensivos, especialmente en casos de síndrome de distrés respiratorio del adulto y encefalitis. Las infecciones por virus influenza y parainfluenza, virus sincitial respiratorio, herpes virus y adenovirus son las que más frecuentemente causan estos cuadros. Se ha realizado una revisión de la literatura pormenorizada y actualizada de epidemiología, patogénesis, manifestaciones clínicas y aproximación terapéutica de las infecciones virales en pacientes inmunocompetentes. Por otro lado, si bien la neumonía asociada a ventilación mecánica tiene como etiología más frecuente las infecciones bacterianas, recientemente el papel de los virus como patógenos en estas infecciones está en debate, por lo que se hace una breve revisión de su papel etiopatogénico en la neumonía asociada a ventilación mecánica.

Palabras clave:
Infecciones virales
Inmunocompetente
SDRA
Unidad de Cuidados Intensivos
Full text is only aviable in PDF
References
[1.]
J. Legoff, E. Guerot, A. Ndjoyi-Mbiguino, M. Matta, A. Si-Mohamed, L. Gutmann, et al.
High prevalence of respiratory viral infecions in patients hospitalized in an Intensive Care Unit for acute respiratory infections as detected by nucleic acid-based assays.
J Clin microbiol, 43 (2005), pp. 455-457
[2.]
J. Johnstone, S.R. Majumdar, J.D. Fox, T.J. Marrie.
Viral infection in adults hospitalized with community-acquired pneumonia.
Chest, 134 (2008), pp. 1141-1148
[3.]
C. Sandrock.
Severe Febrile Respiratory Illnesses as a cause of mass critical care.
Resp Care, 53 (2008), pp. 40-57
[4.]
J.H. Beigel.
Influenza.
Crit Care Med, 36 (2008), pp. 2660-2666
[5.]
C. Breese.
Respiratory Syncytial Virus and Parainfluenza Virus.
N Engl J Med, 344 (2001), pp. 1917-1928
[6.]
S. Manocha, K.R. Walley, J.A. Russell.
Severe acute respiratory syndrome (SARS): A critical care perspective.
Crit Care Med, 31 (2003), pp. 2684-2692
[7.]
C. Sandrock, N. Stollenwerk.
Acute febrile respiratory illness in the ICU.
Chest, 133 (2008), pp. 1221-1231
[8.]
N. Stollenwerk, R.W. Harper, C. Sandrock.
Bench-to-bedside review: Rare and common viral infections in the intensive care unit- linking pathophysiology to clinical presentation.
Crit Care, 12 (2008), pp. 219
[9.]
M. Petric, L. Comanor, C.A. Petti.
Role of the laboratory in diagnosis of influenza during seasonal epidemics and potential pandemics.
JID, 194 (2006), pp. 98-110
[10.]
C. Daubin, S. Vincent, A. Vabret, D. Du Cheyron, J.J. Parienti, M. Ramakers, et al.
Nosocomial viral ventilator-associated pneumonia in the intensive care unit: a prospective cohort study.
Intensive Care Med, 31 (2005), pp. 1116-1122
[11.]
E. Bouza, M. Giannella, M.V. Torres, P. Catalán, C. Sánchez-Carrillo, R.I. Hernandez, on behalf of The Gregorio Marañón Task Force for Pneumonia, et al.
Herpes simplex virus: A marker of severity in bacterial ventilator-associated pneumonia.
[12.]
P. Bruynseels, P.G. Jorens, H.E. Demey, H. Goossens, S.R. Pattyn, M.M. Elseviers, et al.
Herpes simplex virus in the respiratory tract of critical care patients: a prospective study.
Lancet, 362 (2003), pp. 1536-1541
[13.]
G.M. Ong, K. Lowry, S. Mahajan, D.E. Wyatt, C. Simpson, H.J. O’Neill, et al.
Herpes simplex type 1 shedding is associated with reduced hospital survival in patients receiving assisted ventilation in a tertiary referral intensive care unit.
J Med Virol, 72 (2004), pp. 121-125
[14.]
C.H. Cook, L.C. Martin, J.K. Yenchar, M.C. Lahm, B. McGuinness, E.A. Davies, et al.
Occult herpes family viral infections are endemic in critically ill surgical patients.
Crit Care Med, 31 (2003), pp. 1923-1929
[15.]
C.F. Linssen, J.A. Jacobs, F.F. Stelma, W.N. Van Mook, P. Terporten, C. Vink, et al.
Herpes simplex virus load in bronchoalveolar lavage fluid is related to poor outcome in critically ill patients.
Intensive Care Med, 34 (2008), pp. 2202-2209
[16.]
N. De Vos, L. Van Hoovels, A. Vankeerberghen, K. Van Vaerenbergh, A. Boel, I. Demeyer, et al.
Monitoring of herpes simplex virus in the lower respiratory tract of critically ill patients using realtime PCR: a prospective study.
Clin Microbiol Infect, 15 (2009), pp. 358-363
[17.]
L.J. Anderson.
Major trends in nosocomial viral infections.
Am J Med, 91 (1991), pp. S107-S111
[18.]
A.P. Limaye, K.A. Kirby, G.D. Rubenfeld, W.M. Leisenring, E.M. Bulger, M.J. Neff, et al.
Cytomegalovirus reactivation in critically ill immunocompetent patients.
JAMA, 300 (2008), pp. 413-422
[19.]
A.C. Kalil, D.F. Florescu.
Prevalence and mortality associated with cytomegalovirus infection in nonimmunosuppressed patients in the intensive care unit.
Crit Care Med, 37 (2009), pp. 2350-2358
[20.]
L. Chiche, J.M. Forel, A. Roch, C. Guervilly, V. Pauly, J. Allardet-Servent, et al.
Active cytomegalovirus infection is common in mechanically ventilated medical intensive care unit patients.
Crit Care Med, 37 (2009), pp. 1850-1857
[21.]
A.C. Kalil.
A silent killer: cytomegalovirus infection in the nonimmunocompromised critically ill patient.
Crit Care Med, 36 (2008), pp. 3261-3264
[22.]
A. Vincent, B. La Scola, J.M. Forel, V. Pauly, D. Raoult, L. Papazian.
Clinical significance of a positive serology for mimivirus in patients presenting a suspicion of ventilator-associated pneumonia.
Crit Care Med, 37 (2009), pp. 111-118
[23.]
B. La Scola, T.J. Marrie, J.P. Auffray, D. Raoult.
Mimivirus in pneumonia patients.
Emerg Infect Dis, 11 (2005), pp. 449-452
[24.]
C.E. Luyt, A. Combes, C. Deback, M.H. Aubriot-Lorton, A. Nieszkowska, J.L. Trouillet, et al.
Herpes simplex virus lung infection in patients undergoing prolonged mechanical ventilation.
Am J Respir Crit Care Med, 175 (2007), pp. 935-942
[25.]
L. Papazian, A. Fraisse, L. Garbe, C. Zandotti, P. Thomas, P. Saux, et al.
Cytomegalovirus. An unexpected cause of ventilatorassociated pneumonia.
Anesthesiology, 84 (1996), pp. 280-287
[26.]
C.H. Cook, Y. Zhang, D.D. Sedmak, L.C. Martin, S. Jewell, R.M. Ferguson.
Pulmonary cytomegalovirus reactivation causes pathology in immunocompetent mice.
Crit Care Med, 34 (2006), pp. 842-849
[27.]
A.M. Simoons-Smit, E.M. Kraan, A. Beishuizen, R.J. Strack van Schijndel, C.M. Vandenbroucke-Grauls.
Herpes simplex virus type 1 and respiratory disease in critically-ill patients: Real pathogen or innocent bystander?.
Clin Microbiol Infect, 12 (2006), pp. 1050-1059
[28.]
L. Papazian, C. Doddoli, B. Chetaille, Y. Gernez, X. Thirion, A. Roch, et al.
A contributive result of open-lung biopsy improves survival in acute respiratory distress syndrome patients.
Crit Care Med, 35 (2007), pp. 755-762
Copyright © 2011. Elsevier y Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias
Download PDF
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?