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Key Features

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  • Cough, coryza, sore throat

  • Bronchiolitis

  • Detection of viral antigens or nucleic acid in respiratory secretions

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Clinical Findings

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  • Asymptomatic infection is uncommon

  • Fever, cough, rhinorrhea, and sore throat are most common symptoms

  • Bronchiolitis and pneumonia occur in 40–70% of the children who acquire human metapneumovirus infection before the age of 2 years

  • Other manifestations include otitis, conjunctivitis, diarrhea, and myalgia

  • Dual infection with respiratory syncytial virus or other respiratory viruses seems to be a common occurrence and may increase morbidity and mortality

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Diagnosis

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  • Polymerase chain reaction testing on respiratory specimens is preferred method of diagnosis

  • Rapid shell vial culture is an acceptable, albeit less sensitive, alternative

  • Radiography

    • Lower respiratory tract infection frequently shows hyperinflation and patchy pneumonitis

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Treatment

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  • No antiviral therapy is available

  • Ribavirin has in vitro activity against human metapneumovirus, but there are no data to support its therapeutic value

  • Children with lower respiratory tract disease may require hospitalization and ventilatory support

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