Yeşilbaş Osman, Kıhtır Hasan Serdar, Talip Petmezci Mey, Balkaya Seda, Hatipoğlu Nevin, Meşe Sevim, Şevketoğlu Esra
Bakırköy Dr. Sadi Konuk Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey.
Mikrobiyol Bul. 2016 Jan;50(1):159-64. doi: 10.5578/mb.10312.
Human bocavirus (HBoV), that was first identified in 2005 and classified in Parvoviridae family, is a small, non-enveloped, single-stranded DNA virus, responsible for upper and lower respiratory tract infections, especially in young children. Although HBoV generally causes self-limited influenza-like illness, it may also lead to pneumonia, bronchiolitis, croup and asthma attacks. In this report, a case of acute bronchiolitis complicated with pneumomediastinum and bilateral pneumothorax caused by HBoV has been presented. A three-year-old boy was referred to our pediatric intensive care unit with a two day history of fever, tachypnea, hypoxia and respiratory failure. On auscultation, there were widespread expiratory wheezing and inspiratory crackles. The chest radiography yielded paracardiac infiltration and air trapping on the right lung and infiltration on the left lung. The patient had leukocytosis and elevated C-reactive protein level. On the second day of admission, respiratory distress worsened and chest radiography revealed right pneumothorax and subcutaneous emphysema in bilateral cervical region and left chest wall. He was intubated because of respiratory failure. In the thorax computed tomography, pneumomediastinum and bilateral pneumothorax were detected and right chest tube was inserted. Repetitive blood and tracheal aspirate cultures were negative. A nasopharyngeal swab sample was analyzed by multiplex real-time polymerase chain reaction method with the use of viral respiratory panel (FTD(®) Respiratory Pathogens 21 Kit, Fast-Track Diagnostics), and positive result was detected for only HBoV. On the ninth day of admission, pneumomediastinum and bilateral pneumothorax improved completely and he was discharged with cure. In conclusion, HBoV bronchiolitis may progress rare but severe complications, it should be kept in mind as an etiological agent of the respiratory tract infections especially children younger than five years old.
人博卡病毒（HBoV）于2005年首次被发现并归类于细小病毒科，是一种小型、无包膜的单链DNA病毒，可引起上、下呼吸道感染，尤其是在幼儿中。虽然HBoV通常引起自限性流感样疾病，但它也可能导致肺炎、细支气管炎、哮吼和哮喘发作。在本报告中，介绍了一例由HBoV引起的急性细支气管炎并发纵隔气肿和双侧气胸的病例。一名三岁男孩因发热、呼吸急促、缺氧和呼吸衰竭两天被转诊至我们的儿科重症监护病房。听诊时，可闻及广泛的呼气性哮鸣音和吸气性啰音。胸部X线检查显示心旁浸润、右肺空气潴留和左肺浸润。患者白细胞增多，C反应蛋白水平升高。入院第二天，呼吸窘迫加重，胸部X线检查显示右侧气胸以及双侧颈部和左胸壁皮下气肿。由于呼吸衰竭，他接受了插管治疗。胸部计算机断层扫描检测到纵隔气肿和双侧气胸，并插入了右侧胸管。重复的血液和气管吸出物培养均为阴性。使用病毒呼吸道检测板（FTD®呼吸道病原体21试剂盒，快速诊断）通过多重实时聚合酶链反应方法对鼻咽拭子样本进行分析，结果仅检测到HBoV呈阳性。入院第九天，纵隔气肿和双侧气胸完全改善，他治愈出院。总之，HBoV细支气管炎可能进展为罕见但严重的并发症，作为呼吸道感染的病原体，尤其是五岁以下儿童的病原体，应予以重视。
