Korean J Radiol.  2019 Jul;20(7):1226-1235. 10.3348/kjr.2018.0634.

Human Bocavirus Infection in Adults: Clinical Features and Radiological Findings

• Lee HN
• Koo HJ
• Kim SH
• Choi SH
• Sung H
• Do KH

• KMID: 2467033
• DOI: http://doi.org/10.3348/kjr.2018.0634

Abstract

OBJECTIVE
Human bocavirus (HBoV) is a newly identified pathogen that can cause upper and lower respiratory infections usually in children; however, its clinical characteristics and significance in respiratory infections in adults have not been well known. Our objective was to evaluate the clinical features of respiratory HBoV infection and to describe the CT findings of HBoV pneumonia in adults.
MATERIALS AND METHODS
A total of 185 adult patients diagnosed with HBoV infection at a tertiary referral center between January 2010 and December 2017 were retrospectively evaluated with respect to the clinical characteristics of HBoV infection and its risk factors for pneumonia. Chest CT findings for 34 patients with HBoV pneumonia without co-infection were analyzed and compared between immunocompetent (n = 18) and immunocompromised (n = 16) patients.
RESULTS
HBoV infections were predominantly noted between February and June. Among the 185 patients with HBoV infection, 119 (64.3%) had community-acquired infections and 110 (59.5%) had pneumonia. In multivariable analysis, older age (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00-1.04; p = 0.045) and nosocomial infection (OR, 2.07; 95% CI, 1.05-4.10; p = 0.037) were associated with HBoV pneumonia. The main CT findings were bilateral consolidation (70.6%) and/or ground-glass opacities (64.7%); centrilobular nodules (14.7%) were found less frequently. The pattern of CT findings were not significantly different between immunocompetent and immunocompromised patients (all, p > 0.05).
CONCLUSION
HBoV infection can be a potential respiratory tract infection in adults. The most frequent CT findings of HBoV pneumonia were bilateral consolidation and/or ground-glass opacities.

Keyword

Human bocavirus; Pneumonia; Computed tomography

MeSH Terms

Adult*
Child
Coinfection
Community-Acquired Infections
Cross Infection
Human bocavirus*
Humans*
Immunocompromised Host
Pneumonia
Respiratory Tract Infections
Retrospective Studies
Risk Factors
Tertiary Care Centers
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Monthly and yearly distributions of HBoV infections from January 2010 and December 2017.Number of patients with HBoV infections among 185 patients are shown by month (A) and by year (B) according to respiratory site and presence of co-pathogens. HBoV = human bocavirus, URI = upper respiratory infection

• 

  Fig. 2 Flow diagram of patient selection with HBoV infection.

• 

  Fig. 3 30-year-old female without underlying disease was admitted with cough and fever.A, B. CT showed multiple ill-defined centrilobular nodules with bronchial wall thickening (airway centric pattern) in both lungs. Three days later, lesions had resolved completely (not shown).

• 

  Fig. 4 53-year-old male who had undergone liver transplantation eight months earlier presented with fever at emergency department.A, B. Bilateral ground glass opacities and peribronchial consolidations (multifocal pneumonia pattern) without pleural effusion were shown on CT images. He was admitted to intensive care unit, and intubated (not shown). Three weeks after initial presentation, HBoV pneumonia was improved, and patient was discharged uneventfully.

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