Severe parainfluenza pneumonia in a case of transient hypogammalobulinemia of infancy.

Nicola Cotugno, Emma Concetta Manno, Francesca Stoppa, Serena Sinibaldi, Claudia Saffirio, Parizia D'Argenio, Marco Marano, Matteo Di Nardo, Paolo Palma

Research output: Contribution to journalArticle

Abstract

Human parainfluenza viruses (HPIVs) infection, largely known to cause self-limiting bronchiolitis and pneumonia in immune competent patients, can lead to severe to fatal pulmonary disease in immune disorders, such as primary or acquired-immune deficiencies. We report the case of a 1-year-old child who developed an acute respiratory distress syndrome. Because of a progressive respiratory failure unresponsive to conventional treatment extracorporeal membrane oxygenation (ECMO) was rapidly started. HPIV-3 infection was diagnosed on the rhinopharyngeal fluid and immunological examinations revealed a hypogammaglobulinemia. A combination therapy with ribavirin, intravenous immunoglobulin (IVIG) and steroid under ECMO support was started with considerable improvement. Subsequent analysis and more specific immunological assessment resulted normal confirming the diagnosis of transient hypogammaglobulinemia of infancy (THI). This case highlights the importance of prompt therapy with early ECMO support in combination with ribavirin, IVIG and steroids in patients affected by severe HPIV-3 pneumonia and THI.

Original languageEnglish
JournalBMJ Case Reports
Volume2013
Publication statusPublished - 2013

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ASJC Scopus subject areas

  • Medicine(all)

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