Clinical and CT characteristics of human metapneumovirus-associated severe pneumonia in children in Beijing.

Background: Human metapneumovirus (HMPV) has been increasingly appreciated as a cause of lower respiratory tract infection among children. The purpose of this paper is to determine the radiographic and clinical features of children with HMPV lower respiratory disease.

Case presentation: We reviewed seven pediatric patients with severe pneumonia due to HMPV admitted to the Department of Respiratory Medicine, Beijing Children's Hospital were assessed in our study from January to July 2023. Unlike other common viral, lobar or segmental consolidation, air bronchograms, and bronchial wall thickening were the most commonly observed HRCT findings in HMPV-associated pneumonia. C-reactive protein (CRP) levels, ranged 35 mg/L to 146 mg/L, and the median WBC count were significantly increased in children with HMPV-associated pneumonia than the normal level. Two patients were co-detected with Haemophilus influenzae and streptococcus pneumoniae, respectively. Five patients were treated with empirical antibiotics prior to the bacterial test results.

Conclusions: Some pediatric HMPV-associated pneumonias were characterized by lobar or segmental consolidation in CT and the significantly elevated CRP levels, which may mimic Mycoplasma Pneumoniae or bacterial infection. Healthcare providers should consider HMPV as a possible causative pathogen, perform laboratory tests for prompt diagnosis, and limit unnecessary antibiotic treatment.