Are atypical lymphocytes present with viral influenza-like illnesses (ILIs) in hospitalized adults?

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Abstract

The purpose of this investigation was to determine if atypical lymphocytes were of diagnostic value in viral influenza-like illnesses (ILIs) in hospitalized adults during the influenza season. Are atypical lymphocytes present with viral ILIs in hospitalized adults? During the influenza season, hospitals are inundated with influenza and viral ILIs, e.g., human parainfluenza virus-3 (HPIV-3). Without specific testing, clinically, it is difficult to differentiate influenza from ILIs, and surrogate influenza markers have been used for this purpose, e.g., relative lymphopenia. The diagnostic significance of atypical lymphocytes with ILIs is not known. We retrospectively reviewed the charts of 35 adults admitted with pneumonia due to viral ILI. The diagnosis of 14 patients was by respiratory virus polymerase chain reaction (PCR). During the 2015 influenza A season with ILIs, atypical lymphocytes were not present in influenza A (H3N2) patients but atypical lymphocytes were present in some ILIs, particularly HPIV-3. With viral ILIs, atypical lymphocytes should suggest a non-influenza viral diagnosis.

Keywords

Influenza Respiratory Syncytial Virus Influenza Season Respiratory Virus Swine Influenza 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Compliance with ethical standards

Funding

None.

Conflict of interest

None.

Ethical approval

N/A.

Informed consent

N/A.

References

  1. 1.
    Nicholson KG, Webster RG, Hay AJ (eds) (1998) Textbook of influenza. Blackwell Science, OxfordGoogle Scholar
  2. 2.
    Cunha BA, Klein NC, Strollo S, Syed U, Mickail N, Laguerre M (2010) Legionnaires’ disease mimicking swine influenza (H1N1) pneumonia during the “herald wave” of the pandemic. Heart Lung 39:242–248CrossRefPubMedGoogle Scholar
  3. 3.
    Mohan SS, McDermott BP, Cunha BA (2005) The diagnostic and prognostic significance of relative lymphopenia in adult patients with influenza A. Am J Med 118:1307–1309CrossRefGoogle Scholar
  4. 4.
    Hage JE, Petelin A, Cunha BA (2011) Before influenza tests results are available, can droplet precautions be instituted if influenza is suggested by leukopenia, relative lymphopenia, or thrombocytopenia? Am J Infect Control 39:619–621CrossRefPubMedGoogle Scholar
  5. 5.
    Cunha BA, Pherez FM, Strollo S (2009) Swine influenza (H1N1): diagnostic dilemmas early in the pandemic. Scand J Infect Dis 41:900–902CrossRefPubMedGoogle Scholar
  6. 6.
    Criswell BS, Couch RB, Greenberg SB, Kimzey SL (1979) The lymphocyte response to influenza in humans. Am Rev Respir Dis 120:700–704PubMedGoogle Scholar
  7. 7.
    Cunha BA, Pherez FM, Schoch P (2009) Diagnostic importance of relative lymphopenia as a marker of swine influenza (H1N1) in adults. Clin Infect Dis 49:1454–1456CrossRefPubMedGoogle Scholar
  8. 8.
    Coşkun O, Avci IY, Sener K, Yaman H, Ogur R, Bodur H, Eyigün CP (2010) Relative lymphopenia and monocytosis may be considered as a surrogate marker of pandemic influenza A (H1N1). J Clin Virol 47:388–389CrossRefPubMedGoogle Scholar
  9. 9.
    Delamore IW, Liu Yin JA (eds) (1990) Haematological aspects of systemic disease. Baillière Tindall, London, pp 8–10Google Scholar
  10. 10.
    Cunha CB (2015) Infectious disease differential diagnosis. In: Cunha BA (ed) Antibiotic essentials, 14th edn. JayPee Medical Publishers, New Delhi, pp 495–498Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Infectious Disease DivisionWinthrop University HospitalMineolaUSA
  2. 2.School of MedicineState University of New YorkStony BrookUSA

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