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口服利巴韦林对免疫功能正常患者呼吸道合胞病毒所致急性呼吸窘迫综合征可能的治疗作用:一例病例报告

Possible therapeutic effect of orally administered ribavirin for respiratory syncytial virus-induced acute respiratory distress syndrome in an immunocompetent patient: a case report.

作者信息

Yoon Byung Woo, Lee Seung Hyeun

机构信息

Department of Internal Medicine, Hanil General Hospital, Seoul, Republic of Korea.

Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

出版信息

J Med Case Rep. 2017 Dec 20;11(1):353. doi: 10.1186/s13256-017-1514-x.

Abstract

BACKGROUND

Human respiratory syncytial virus usually causes self-limiting upper respiratory infection and occasionally causes pneumonia in immunocompromised hosts. Respiratory syncytial virus-induced severe pneumonia or acute respiratory distress syndrome in immunocompetent adults has been rarely described. Unfortunately, optimal treatment has not been established for this potentially fatal condition. We report a case of respiratory syncytial virus-induced acute respiratory distress syndrome occurring in a previously healthy man successfully treated with orally administered ribavirin.

CASE PRESENTATION

An 81-year-old previously healthy Korean man presented with cough, dyspnea, and febrile sensation. He had hypoxemia with diffuse ground glass opacity evident on chest radiography, which progressed and required mechanical ventilation. All microbiological tests were negative except multiplex real-time reverse transcriptase polymerase chain reaction using respiratory specimen, which was positive for human adenovirus. Under the diagnosis of respiratory syncytial virus-induced acute respiratory distress syndrome, orally administered ribavirin was administered and he recuperated completely without complications.

CONCLUSION

This case demonstrates the potential usefulness of orally administered ribavirin as a therapeutic option for severe respiratory syncytial virus infection, at least in an immunocompetent host.

摘要

背景

人呼吸道合胞病毒通常引起自限性上呼吸道感染,偶尔在免疫功能低下的宿主中引起肺炎。免疫功能正常的成年人中,呼吸道合胞病毒引起的严重肺炎或急性呼吸窘迫综合征鲜有报道。不幸的是,对于这种潜在致命疾病尚未确立最佳治疗方法。我们报告一例呼吸道合胞病毒引起的急性呼吸窘迫综合征,发生在一名既往健康的男性身上,经口服利巴韦林成功治愈。

病例介绍

一名81岁既往健康的韩国男性出现咳嗽、呼吸困难和发热感。他存在低氧血症,胸部X线显示弥漫性磨玻璃影,病情进展并需要机械通气。除了使用呼吸道标本进行的多重实时逆转录聚合酶链反应外,所有微生物学检查均为阴性,该检查显示人腺病毒阳性。在诊断为呼吸道合胞病毒引起的急性呼吸窘迫综合征后,给予口服利巴韦林治疗,他完全康复且无并发症。

结论

该病例表明,口服利巴韦林作为严重呼吸道合胞病毒感染的一种治疗选择具有潜在作用,至少在免疫功能正常的宿主中如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5738173/54281d6e64c8/13256_2017_1514_Fig1_HTML.jpg

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