From the Research
Yes, human metapneumovirus (hMPV) can cause organizing pneumonia, as evidenced by recent studies, including a 2019 analysis that highlights its role in severe community-acquired pneumonia in adults 1. Organizing pneumonia is a specific pattern of lung injury characterized by the formation of granulation tissue within alveolar spaces, which can occur as a response to various infectious agents, including viral pathogens like hMPV. While hMPV more commonly causes bronchiolitis and typical pneumonia, particularly in children, elderly, and immunocompromised individuals, it has been documented as a trigger for organizing pneumonia in some cases. The development of organizing pneumonia following hMPV infection likely results from an exaggerated inflammatory response to the viral infection, leading to alveolar damage and subsequent abnormal healing with fibroblast proliferation and collagen deposition. Some key points to consider include:
- The clinical features of hMPV-associated disease are similar to those of other respiratory viral infections, ranging from mild to severe symptoms 2.
- Diagnosis of hMPV infection is preferred through molecular methods such as reverse transcription-polymerase chain reaction (RT-PCR) due to the virus's slow growth in cell culture 3, 4.
- Patients with hMPV-associated organizing pneumonia typically present with persistent respiratory symptoms, including cough, dyspnea, and sometimes fever, that fail to resolve with standard antibiotic therapy.
- Treatment generally involves corticosteroids, which usually results in good clinical response, although the specific dosage and duration can vary based on the patient's condition and response to treatment. Given the potential severity of hMPV infections, especially in vulnerable populations, and the lack of specific antiviral treatments or vaccines approved for use, the most appropriate approach is to prioritize supportive care and monitor for complications, with corticosteroids being a key component in managing organizing pneumonia associated with hMPV infection 1.