Ebola virus disease complicated with viral interstitial pneumonia: A case report

Nicola Petrosillo, Emanuele Nicastri, Simone Lanini, Maria Rosaria Capobianchi, Antonino Di Caro, Mario Antonini, Vincenzo Puro, Francesco Nicola Lauria, Nakono Shindo, Nicola Magrini, Gary P. Kobinger, Giuseppe Ippolito, Vincenzo Puro, Mario Antonini, Antonio Russo, Antonella Petrecchia, Evangelo Boumis, Marco Gentile, Damiano Travaglini, Silvia PittalisLorena Martini, Concetta Castilletti, Francesco Maria Fusco, Simone Lanini, Andrea Antinori, Giuseppe Ippolito, Valerio Fabio Alberti, Nazario Bevilacqua, Evangelo Boumis, Stefania Cicalini, Pierangelo Chinello, Angela Corpolongo, Andrea Mariano, Fabrizio Taglietti, Laura Vincenzi, Telma Azevedo, Mario Antonini, Ilaria Caravella, Gabriele Garotto, Luisa Marchioni, Micaela Maritti, Gianni Battisti, Alessanda Coppola, Loredana De Marchis, Nicola De Marco, Fabio Di Gianbattista, Mario Guiducci, Daniela Imola, Antonio Marasco, Antonella Marzolini, Alessandro Mercuri, Paola Nieddu, Silvia Ondedei, Maurizio Vescovo, Laura Vitolo, Elisa Busi Rizzi, Silvia Murachelli, Maria Rosaria Capobianchi, Antonino di Caro, Concetta Castilletti, Licia Bordi, Eleonora Lalle, Silvia Meschi, Daniele Lapa, Patrizia Marsella, Francesca Colavita, Roberta Chiappini, Antonio Mazzarelli, Serena Quartu, Chiara Agrati, Fabrizio Carletti, Federica Forbici, Maria Beatrice Valli, Isabella Abbate, Alessandra Amendola, Anna Rosa Garbuglia, Maria Grazia Paglia, Eugenio Bordi, Antonietta Toffoletti, Gaetano Battisti, Marco Liguori, Paolo D'Aprile, Raffaella Barbaro, Lorella Salce, Daniela Renna, Simona Barbato, Paola Vaccaro, Francesco Bianchini

Research output: Contribution to journalArticle

Abstract

Background: In the current Ebola epidemic in Western Africa, many healthcare workers have become infected. Some of these have been medically evacuated to hospitals in Europe and the USA. These clinical experiences provide unique insights into the course of Ebola virus disease under optimized condition within high level isolation units. Case presentation: A 50-year-old Caucasian male physician contracted Ebola virus diseases in Sierra Leone and was medically evacuated to Italy. Few days after the admission the course of the illness was characterized by severe gastro-intestinal symptoms followed by respiratory failure, accompanied by pulmonary infiltration and high Ebola viral load in the bronchial aspirate and Plasmodium vivax co-infection. The patient received experimental antiviral therapy with favipiravir, convalescent plasma and ZMAb. Ebola viral load started to steadily decrease in the blood after ZMAb administration and became undetectable by day 19 after admission, while it persisted longer in urine samples. No temporal association was observed between viral load decay in plasma and administration of favipiravir. The patient completely recovered and was discharged 39days after admission. Conclusions: This is the first case of Ebola-related interstitial pneumonia documented by molecular testing of lung fluid specimens. This reports underlines the pivotal role of fluid replacement and advanced life support with mechanical ventilation in the management of patients with Ebola virus diseases respiratory failure. Beside our finding indicates a close temporal association between administration of cZMAb and Ebola virus clearance from blood.

Original languageEnglish
Article number432
JournalBMC Infectious Diseases
Volume15
Issue number1
DOIs
Publication statusPublished - Oct 16 2015

Keywords

  • Antibodies, monoclonal
  • Ebola
  • Favipiravir
  • Fluid therapy
  • Hemorrhagic fever
  • Hospitals, isolation
  • Immunization, passive
  • Life support care
  • Malaria, vivax
  • Pneumonia, viral

ASJC Scopus subject areas

  • Infectious Diseases

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