Rodriguez-Nava Guillermo, Shrestha Ekta, Upadhyay Binayak, Morante Aldo, Joseph Deepa, Suhail Aimen, Trelles-Garcia Daniela Patricia, Yanez-Bello Maria Adriana
Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL 60202, United States.
IDCases. 2020 Jun 30;21:e00894. doi: 10.1016/j.idcr.2020.e00894. eCollection 2020.
Diffuse alveolar hemorrhage is a condition with high morbidity and mortality. The majority of cases are caused by pulmonary capillaritis associated with systemic vasculitis. Infection disease has also been associated with this condition. A 62-year-old woman with a history of chronic alcohol abuse presented with shortness of breath, hemoptysis, constipation, and icterus. Chest x-rays on admission showed diffuse patchy opacities concerning for diffuse alveolar hemorrhage. The patient quickly developed acute respiratory failure requiring intubation. PCR identified human metapneumovirus and bronchoalveolar lavage confirmed alveolar hemorrhage. Despite all efforts, the patient ultimately developed multi-organ failure and died. Human metapneumovirus is usually associated with mild upper and lower respiratory tract infections in young children. Nevertheless, clinicians should recognize that this virus has recently emerged as a significant pathogen, particularly in adult patients with underlying conditions and the elderly population.
弥漫性肺泡出血是一种发病率和死亡率都很高的病症。大多数病例由与系统性血管炎相关的肺毛细血管炎引起。感染性疾病也与这种病症有关。一名有慢性酒精滥用史的62岁女性出现呼吸急促、咯血、便秘和黄疸。入院时胸部X光显示弥漫性斑片状模糊影，提示弥漫性肺泡出血。患者很快发展为急性呼吸衰竭，需要插管。聚合酶链反应检测出人偏肺病毒，支气管肺泡灌洗证实存在肺泡出血。尽管全力救治，患者最终仍发展为多器官功能衰竭并死亡。人偏肺病毒通常与幼儿的轻度上、下呼吸道感染有关。然而，临床医生应认识到，这种病毒最近已成为一种重要病原体，尤其是在有基础疾病的成年患者和老年人群中。
