Grodin J L, Wu K S, Kitchell E E, Le J, Mishkin J D, Drazner M H, Markham D W
Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA.
Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA ; Division of Infectious Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA.
Case Rep Cardiol. 2012;2012:723407. doi: 10.1155/2012/723407. Epub 2011 Oct 27.
Respiratory syncytial virus (RSV) is an important community-acquired pathogen that can cause significant morbidity and mortality in patients who have compromised pulmonary function, are elderly, or are immunosuppressed. This paper describes a 70-year-old man with a remote history of heart transplantation who presented with signs and symptoms of pneumonia. Chest computed tomography (CT) imaging demonstrated new patchy ground glass infiltrates throughout the upper and lower lobes of the left lung, and the RSV direct fluorescence antibody (DFA) was positive. The patient received aerosolized ribavirin, one dose of intravenous immunoglobulin, and one dose of palivizumab. After two months of followup, the patient had improved infiltrates on chest CT, improved pulmonary function testing, and no evidence of graft rejection or dysfunction. There are few data on RSV infections in heart transplant patients, but this case highlights the importance of considering this potentially serious infection and introduces a novel method of treatment.
呼吸道合胞病毒（RSV）是一种重要的社区获得性病原体，可导致肺功能受损、老年人或免疫抑制患者出现严重发病和死亡。本文描述了一名有心脏移植史的70岁男性，他出现了肺炎的体征和症状。胸部计算机断层扫描（CT）成像显示左肺上下叶出现新的斑片状磨玻璃影，RSV直接荧光抗体（DFA）检测呈阳性。患者接受了雾化利巴韦林、一剂静脉注射免疫球蛋白和一剂帕利珠单抗治疗。经过两个月的随访，患者胸部CT上的浸润影有所改善，肺功能测试结果改善，且无移植物排斥或功能障碍的迹象。关于心脏移植患者感染RSV的数据很少，但该病例凸显了考虑这种潜在严重感染的重要性，并介绍了一种新的治疗方法。
