Clinical Challenges

Norovirus in Immunocompromised Patients

Jill Atmar

Ellen C. Mullen

immunocompromised patients
ONF 2013, 40(5), 434-436. DOI: 10.1188/13.ONF.434-436

While undergoing a routine mammogram, Mrs. B, age 76 years and in good health, was found to have right axillary adenopathy. A core biopsy confirmed the diagnosis of follicular lymphoma and she was referred to an oncologist who recommended treatment with six cycles of bendamustine, mitoxantrone, and rituximab. She tolerated the treatment fairly well except for mild lower abdominal discomfort for three to four days following infusion of chemotherapy. Prior to her fifth cycle of therapy, she reported chills, vomiting, and watery diarrhea without fever. Mrs. B volunteered one day per week at a nursing home and she noted that a stomach virus had circulated among the residents. Her symptoms resolved five days after her initial episode occurred and she proceeded with her fifth cycle of therapy.

Jump to a section

    References

    Atmar, R., & Estes, M. K. (2006). The epidemiologic and clinical importance of norovirus infection. Gastroenterology Clinics of North America, 35, 275-290. doi:10.1016/i.gtc.2006.03.001
    Hall, A., Vinje, J., Lopman, B., Park, G., Yen, C., Gregoricus, N., & Parashar, U. (2011). Updated norovirus outbreak management and disease prevention guidelines. Morbidity and Mortality Weekly Report, 60(3), 1-15.
    Koo, H., Ajami, N., Atmar, R., & DuPont, H. (2010). Noroviruses: The leading cause of gastroenteritis worldwide. Discovery Medicine, 87(10), 61-70.
    Patel, M., Hall, A., Vinje, J., & Parashar, U. (2009). Noroviruses: A comprehensive review. Journal of Clinical Virology, 44, 1-8.
    Atmar, R., Bernstein, D., Harro, C., Al-Ibrahim, M., Chen, S., Ferreira, J., … Mendelman, P. (2011). Norovirusvaccine against experimental human Norwalk virus illness. New England Journal of Medicine, 365, 2178-2187.
    Atmar, R., & Estes, M. K. (2006). The epidemiologic and clinical importance of norovirus infection. Gastroenterology Clinics of North America, 35, 275-290. doi:10.1016/i.gtc.2006.03.001
    Atmar, R., Opekun, A., Gilger, M., Estes, M. K., Crawford, S., Neill, F., & Graham, D. (2008). Norwalk virus shedding after experimental human infection. Emerging Infectious Diseases, 14, 1-5. doi:10.3201/eid1410.080117
    Estes, M. K., Prasad, B. V., & Atmar, R. (2006). Noroviruses everywhere: Has something changed? Current Opinions in Infectious Disease, 19, 467-474.
    Glass, R., Parashar, U., & Estes, M. K., (2010). Norovirus gastroenteritis. New England Journal of Medicine, 361, 1776-1785.
    Hall, A., Vinje, J., Lopman, B., Park, G., Yen, C., Gregoricus, N., & Parashar, U. (2011). Updated norovirus outbreak management and disease prevention guidelines. Morbidity and Mortality Weekly Report, 60(3), 1-15.
    Healthcare Infection Control Practices Advisory Committee. (2011). Guidelines for the prevention and control of norovirus gastroenteritis outbreaks. Retrieved from http://1.usa.gov/jSCQbw
    Kaplan, J. E., Feldman, R., Campbell, D. S., Lookabaugh, C., & Gary, G. W. (1982). The frequency of a Norwalk-like pattern of illness in outbreaks of acute gastroenteritis. American Journal of Public Health, 72, 1329-1332.
    Koo, H., Ajami, N., Atmar, R., & DuPont, H. (2010). Noroviruses: The leading cause of gastroenteritis worldwide. Discovery Medicine, 87(10), 61-70.
    Patel, M., Hall, A., Vinje, J., & Parashar, U. (2009). Noroviruses: A comprehensive review. Journal of Clinical Virology, 44, 1-8.
    Roddie, C., Paul, P., Benjamin, P., Gallimore, C., Xerry, J., Gray, J., … Ward, K. N. (2009). Allogeneic hematopoietic stem cell tansplantation and norovirus gastroenteritis. Clinical Infectious Diseases, 49, 1061-1068.
    Scallan, C., Hoestra, R. M., Angelo, F. J., Tauxe, R. V., Willowson, M. A., Roy, S. L., … Griffin, P. M. (2011). Foodborne illness acquired in the United States. Emerging Infectious Diseases, 17, 7-15.