Flynn Jeremy D, Akers Wendell S, Jones Mikael, Stevkovic Natasa, Waid Thomas, Mullett Timothy, Jahania Salik
Department of Pharmacy Services, University of Kentucky Chandler Medical Center, College of Medicine, University of Kentucky, Lexington, Kentucky 40536-0293, USA.
Pharmacotherapy. 2004 Jul;24(7):932-8. doi: 10.1592/phco.24.9.932.36090.
A 61-year-old woman who underwent lung transplantation developed severe respiratory syncytial virus (RSV) pneumonia and experienced respiratory failure requiring mechanical ventilation. She was treated initially with aerosolized ribavirin monotherapy; RSV hyperimmune globulin was later added to her regimen. Lung transplant recipients are acutely susceptible to respiratory infections, including community-acquired respiratory viruses. Respiratory syncytial virus is particularly difficult to treat in immunocompromised patients because of the lack of proved pharmaceutical agents and solid scientific evidence by which to guide therapy. The most important factor appears to be the early start of therapy; immunocompromised patients who develop RSV pneumonia and subsequent respiratory failure requiring mechanical ventilation have a mortality rate approaching 100%. This case report demonstrates the successful treatment of RSV pneumonia with the combination of aerosolized ribavirin and RSV hyperimmune globulin in a severely ill lung transplant recipient who required mechanical ventilation.
一名接受肺移植的61岁女性患上了严重的呼吸道合胞病毒（RSV）肺炎，并出现呼吸衰竭，需要机械通气。她最初接受雾化利巴韦林单一疗法治疗；后来在治疗方案中加入了RSV高免疫球蛋白。肺移植受者对包括社区获得性呼吸道病毒在内的呼吸道感染极为敏感。由于缺乏经证实的药物和可靠的科学证据来指导治疗，呼吸道合胞病毒在免疫功能低下的患者中尤其难以治疗。最重要的因素似乎是尽早开始治疗；患上RSV肺炎并随后出现需要机械通气的呼吸衰竭的免疫功能低下患者，死亡率接近100%。本病例报告展示了在一名需要机械通气的重症肺移植受者中，雾化利巴韦林与RSV高免疫球蛋白联合治疗RSV肺炎取得成功。
