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Really unfrequent?" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "182" "paginaFinal" => "183" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jordi Reina, Antonio Iñigo, Javier Murillas" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Jordi" "apellidos" => "Reina" "email" => array:1 [ 0 => "jorge.reina@ssib.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Antonio" "apellidos" => "Iñigo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Javier" "apellidos" => "Murillas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Son Espases, Palma de Mallorca, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infecciones respiratorias agudas por bocavirus humanos en la población adulta ¿una rareza?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Human bocaviruses were first described by Allander et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> in 2005, as the cause of acute respiratory infections (ARI) in children. These viruses have a universal distribution and, in addition to ARI show a gastrointestinal profile.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">ARI caused by bocavirus in the adult population are very rare<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a>; we therefore expose herein a prospective study carried out over the last 3 years.</p><p id="par0015" class="elsevierStylePara elsevierViewall">During the period between February 2013 and April 2015 a prospective study on acute ARI caused by the bocavirus in the adult population was carried out. All patients with clinically suspected ARI who were admitted to A&E of the University Hospital Son Espases, in Palma de Mallorca, were given a throat swab. The detection of different respiratory viruses was conducted using a commercial genomic amplification technique, RT-PCR, in real-time (Anyplex<span class="elsevierStyleSup">®</span> RV16; Seegen, South Korea). The medical records of patients identified with bocavirus were reviewed.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Throughout the study 2881 respiratory specimens were analysed, of which 1543 (53.5%) were considered positive (viral detection). The presence of the bocavirus was detected in 6 patients, representing 0.2% of all samples studied and 0.38% of the positive samples.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In the same period 125 cases of ARI were detected in paediatric patients (<15 years); the 6 adult cases represented 4.5% of all detected bocavirus. 67.9% of all bocavirus were detected between January and March, including the adult cases. The 6 patients corresponded to 4 men (66.6%) and 2 women (33.3%). The mean age of patients was 49.1 years (range 34–65 years), 66.6% fell into the 50–64 year age-group. One patient (16.6%) was co-infected with a rhinovirus.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Of the 6 patients, 2 had pneumonia, 2 acute tracheobronchitis, a reactivation of their COPD and respiratory distress. Two of them were immunosuppressed because of a lymphoma and an HIV infection. The main symptoms were fever, cough, phlegm, runny nose and headache; none had diarrhoea. All patients were admitted and none died of the viral infection.</p><p id="par0035" class="elsevierStylePara elsevierViewall">ARI caused by bocavirus occurs throughout life, but it clearly predominates in children, especially in those who are less than 5 years old.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> It is rare in adults, and the overall incidence varies between 0.1 and 0.5% of respiratory samples studied,<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4–8</span></a> and between 0.3 and 3% of the positive samples of some respiratory viruses.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8–10</span></a> In our case, the percentages obtained are very similar to those already reported and confirms the low incidence of this type of viral infection. Similarly, several studies have confirmed the predominance these infections affecting children, such that bocavirus in adults is represented by only 3–5% of all detected cases (4.5% in our study).<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7,8</span></a> The ARI caused by bocavirus in paediatrics are presented preferably as viral co-infections (50–80%), predominating influenza viruses and rhinoviruses.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> 16.6% of our adult patients were co-infected with rhinovirus, although the low number of case studies does confirm these results.</p><p id="par0040" class="elsevierStylePara elsevierViewall">There are hardly any comprehensive studies of the adult population, but most cases seem to indicate that fever, cough, rhinitis, pharyngitis, phlegm, headache and respiratory distress are the most common clinical manifestations.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,5,9</span></a> All of them are indistinguishable from other viral respiratory diseases.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Most clinical diagnoses are tracheitis/tracheobronchitis, pneumonia and respiratory distress.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,8,10</span></a> Our patients had these same symptoms, resulting in hospitalisation. A predominance in immunocompromised patients has not been reported, but in our study 33.3% of them belonged to this category. However, all clinical profiles were self-limiting and were discharged after less than 5 days.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The bocavirus also been implicated in diarrhoeal diseases, but in the adult population this clinical manifestation is rare (10–12%)<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3,7</span></a>; none of our patients presented this symptom, not even nausea or vomiting.</p><p id="par0055" class="elsevierStylePara elsevierViewall">ARI by human bocavirus is very rare and indistinguishable from other viral respiratory infections. Only the use of molecular techniques will reveal its true incidence and clinical significance in adults.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Reina J, Iñigo A, Murillas J. Infecciones respiratorias agudas por bocavirus humanos en la población adulta ¿una rareza? Med Clin (Barc). 2016;146:182–183.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cloning of a human parvovirus by molecular screening of respiratory tract samples" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Allander" 1 => "M.T. Tammi" 2 => "M. 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