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 language | English |
|---|---|
| Article number | 432 |
| Journal | BMC Infectious Diseases |
| Volume | 15 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Oct 16 2015 |
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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
Cite this
Ebola virus disease complicated with viral interstitial pneumonia : A case report. / Petrosillo, Nicola; Nicastri, Emanuele; Lanini, Simone; Capobianchi, Maria Rosaria; Di Caro, Antonino; Antonini, Mario; Puro, Vincenzo; Lauria, Francesco Nicola; Shindo, Nakono; Magrini, Nicola; Kobinger, Gary P.; Ippolito, Giuseppe; Puro, Vincenzo; Antonini, Mario; Russo, Antonio; Petrecchia, Antonella; Boumis, Evangelo; Gentile, Marco; Travaglini, Damiano; Pittalis, Silvia; Martini, Lorena; Castilletti, Concetta; Fusco, Francesco Maria; Lanini, Simone; Antinori, Andrea; Ippolito, Giuseppe; Alberti, Valerio Fabio; Bevilacqua, Nazario; Boumis, Evangelo; Cicalini, Stefania; Chinello, Pierangelo; Corpolongo, Angela; Mariano, Andrea; Taglietti, Fabrizio; Vincenzi, Laura; Azevedo, Telma; Antonini, Mario; Caravella, Ilaria; Garotto, Gabriele; Marchioni, Luisa; Maritti, Micaela; Battisti, Gianni; Coppola, Alessanda; Marchis, Loredana De; De Marco, Nicola; Gianbattista, Fabio Di; Guiducci, Mario; Imola, Daniela; Marasco, Antonio; Marzolini, Antonella; Mercuri, Alessandro; Nieddu, Paola; Ondedei, Silvia; Vescovo, Maurizio; Vitolo, Laura; Rizzi, Elisa Busi; Murachelli, Silvia; Capobianchi, Maria Rosaria; di Caro, Antonino; Castilletti, Concetta; Bordi, Licia; Lalle, Eleonora; Meschi, Silvia; Lapa, Daniele; Marsella, Patrizia; Colavita, Francesca; Chiappini, Roberta; Mazzarelli, Antonio; Quartu, Serena; Agrati, Chiara; Carletti, Fabrizio; Forbici, Federica; Valli, Maria Beatrice; Abbate, Isabella; Amendola, Alessandra; Garbuglia, Anna Rosa; Paglia, Maria Grazia; Bordi, Eugenio; Toffoletti, Antonietta; Battisti, Gaetano; Liguori, Marco; D'Aprile, Paolo; Barbaro, Raffaella; Salce, Lorella; Renna, Daniela; Barbato, Simona; Vaccaro, Paola; Bianchini, Francesco.
In: BMC Infectious Diseases, Vol. 15, No. 1, 432, 16.10.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ebola virus disease complicated with viral interstitial pneumonia
T2 - A case report
AU - Petrosillo, Nicola
AU - Nicastri, Emanuele
AU - Lanini, Simone
AU - Capobianchi, Maria Rosaria
AU - Di Caro, Antonino
AU - Antonini, Mario
AU - Puro, Vincenzo
AU - Lauria, Francesco Nicola
AU - Shindo, Nakono
AU - Magrini, Nicola
AU - Kobinger, Gary P.
AU - Ippolito, Giuseppe
AU - Puro, Vincenzo
AU - Antonini, Mario
AU - Russo, Antonio
AU - Petrecchia, Antonella
AU - Boumis, Evangelo
AU - Gentile, Marco
AU - Travaglini, Damiano
AU - Pittalis, Silvia
AU - Martini, Lorena
AU - Castilletti, Concetta
AU - Fusco, Francesco Maria
AU - Lanini, Simone
AU - Antinori, Andrea
AU - Ippolito, Giuseppe
AU - Alberti, Valerio Fabio
AU - Bevilacqua, Nazario
AU - Boumis, Evangelo
AU - Cicalini, Stefania
AU - Chinello, Pierangelo
AU - Corpolongo, Angela
AU - Mariano, Andrea
AU - Taglietti, Fabrizio
AU - Vincenzi, Laura
AU - Azevedo, Telma
AU - Antonini, Mario
AU - Caravella, Ilaria
AU - Garotto, Gabriele
AU - Marchioni, Luisa
AU - Maritti, Micaela
AU - Battisti, Gianni
AU - Coppola, Alessanda
AU - Marchis, Loredana De
AU - De Marco, Nicola
AU - Gianbattista, Fabio Di
AU - Guiducci, Mario
AU - Imola, Daniela
AU - Marasco, Antonio
AU - Marzolini, Antonella
AU - Mercuri, Alessandro
AU - Nieddu, Paola
AU - Ondedei, Silvia
AU - Vescovo, Maurizio
AU - Vitolo, Laura
AU - Rizzi, Elisa Busi
AU - Murachelli, Silvia
AU - Capobianchi, Maria Rosaria
AU - di Caro, Antonino
AU - Castilletti, Concetta
AU - Bordi, Licia
AU - Lalle, Eleonora
AU - Meschi, Silvia
AU - Lapa, Daniele
AU - Marsella, Patrizia
AU - Colavita, Francesca
AU - Chiappini, Roberta
AU - Mazzarelli, Antonio
AU - Quartu, Serena
AU - Agrati, Chiara
AU - Carletti, Fabrizio
AU - Forbici, Federica
AU - Valli, Maria Beatrice
AU - Abbate, Isabella
AU - Amendola, Alessandra
AU - Garbuglia, Anna Rosa
AU - Paglia, Maria Grazia
AU - Bordi, Eugenio
AU - Toffoletti, Antonietta
AU - Battisti, Gaetano
AU - Liguori, Marco
AU - D'Aprile, Paolo
AU - Barbaro, Raffaella
AU - Salce, Lorella
AU - Renna, Daniela
AU - Barbato, Simona
AU - Vaccaro, Paola
AU - Bianchini, Francesco
PY - 2015/10/16
Y1 - 2015/10/16
N2 - 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.
AB - 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.
KW - Antibodies, monoclonal
KW - Ebola
KW - Favipiravir
KW - Fluid therapy
KW - Hemorrhagic fever
KW - Hospitals, isolation
KW - Immunization, passive
KW - Life support care
KW - Malaria, vivax
KW - Pneumonia, viral
UR - http://www.scopus.com/inward/record.url?scp=84944871744&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84944871744&partnerID=8YFLogxK
U2 - 10.1186/s12879-015-1169-4
DO - 10.1186/s12879-015-1169-4
M3 - Article
VL - 15
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
IS - 1
M1 - 432
ER -