Abstract

Human metapneumovirus (hMPV) is an important cause of acute infections of the respiratory system affecting young children, older adults, and immunocompromised individuals. Patients suffering from chronic obstructive pulmonary disease (COPD) and end-stage renal disease (ESRD) receiving maintenance hemodialysis represent a particularly vulnerable population, yet published reports describing hMPV infection in dialysis patients remain limited.

A 70-year-old male with a background of COPD, hypertension, and diabetic nephropathy with a maintenance hemodialysis regimen presented with a four-day history of fever, cough with rhinorrhea, myalgias, and dyspnea. He was immunized against influenza, COVID-19, and RSV. Physical examination showed signs of mild hypoxemia with diffuse crackles and expiratory wheezing, without evidence of consolidation. The patient’s chest radiograph showed chronic obstructive changes. Triplex RT-PCR for influenza virus, RSV, and SARS-CoV-2 was negative. However, a multiplex RT-PCR respiratory panel identified hMPV. He had a good response to supportive care with oxygen supplementation, bronchodilator therapy, and continuation of his scheduled hemodialysis regimen, with subsequent discharge after five days.

The above-mentioned case shows how crucial it is to consider the possible hMPV infection in differentiating the cause of respiratory complaints in dialysis patients. This infection, even being a relatively mild one, can have serious consequences from the point of view of infection control in dialysis units due to close contact between patients and their frequent use of common medical devices. This observation highlights the clinical significance of hMPV infections in hemodialysis patients.