Yousefi Meysam, Nadji Seyed Alireza, Farzanegan Behrooz, Hashemian Seyed Mohammad Reza, Marjani Majid, Moniri Afshin, Javanmard Pedram, Tabarsi Payam
Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran.
Virology Research Center (VRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2019 Feb;18(2):169-172.
A 35- year- old man with a prior history of liver transplantation 18 months ago was admitted to our Intensive Care Unit (ICU) with fever and worsening dyspnea and was diagnosed with severe pneumonia leading to Acute Respiratory Distress Syndrome (ARDS). He had a prolonged hospitalization and was treated with empiric broad spectrum intravenous antibiotics, oseltamivir, trimethoprim/sulfamethoxazole, and subsequently caspofungin and ganciclovir. Blood, nasopharyngeal, as well as Bronchoalveolar Lavage (BAL) culture and Polymerase Chain Reaction (PCR) were negative for all viral, bacterial, and fungal causes of pulmonary infection except Enterovirus-Human Rhinovirus (EV-HRV) that was positive with high titers on BAL and swab specimens. Consequently, the diagnosis of EV-HRV pneumonia complicated by ARDS was established. The patient gradually improved and was discharged from the hospital after 3 weeks. This report highlights EV-HRV as a cause of ARDS in immunocompromised adults.
一名35岁男性，18个月前有肝移植病史，因发热和进行性加重的呼吸困难入住我院重症监护病房（ICU），被诊断为重症肺炎并导致急性呼吸窘迫综合征（ARDS）。他住院时间较长，接受了经验性广谱静脉抗生素、奥司他韦、甲氧苄啶/磺胺甲恶唑治疗，随后使用了卡泊芬净和更昔洛韦。血液、鼻咽以及支气管肺泡灌洗（BAL）培养和聚合酶链反应（PCR）检测结果显示，除肠道病毒-人鼻病毒（EV-HRV）外，所有肺部感染的病毒、细菌和真菌病因均为阴性，而BAL和拭子标本上EV-HRV呈高滴度阳性。因此，确诊为EV-HRV肺炎并发ARDS。患者逐渐好转，3周后出院。本报告强调了EV-HRV是免疫功能低下成人ARDS的一个病因。
