The Holy Family Hospital, Warsaw, Poland.
Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland.
Adv Exp Med Biol. 2021;1324:29-34. doi: 10.1007/5584_2020_602.
This paper presents a case of coinfection of influenza A virus (H1N1) and respiratory syncytial virus (RSV) in a male newborn. On the first day of life, the newborn required passive oxygen therapy, followed by respiratory support with nasal continuous positive airway pressure (nCPAP) due to respiratory insufficiency. As the newborn's respiratory effort was intensifying, he was intubated. In the second day of life, a nasopharyngeal swab was taken yielding the presence of H1N1 and RSV in the RT-PCR test. The child was isolated and given oseltamivir and empirical antibiotic therapy, which improved his condition. Other newborns who initially stayed with the sick child in the post-delivery room did not obtain oseltamivir prophylactically as their nasopharyngeal swabs were negative. The child's parents denied the occurrence of influenza-like symptoms within 14 days of delivery, which suggests a transplacental transmission of the child's infection or asymptomatic course of infection in the parents. In conclusion, this report confirms the possibility of viral coinfections in newborns, which points attention to considering a panel of respiratory viruses in the diagnostics. Symptoms of influenza in newborns may be atypical, including a fever-free course. Oseltamivir treatment in newborns with influenza seems an effective therapeutic measure.
本文报告了一例男性新生儿同时感染甲型流感病毒（H1N1）和呼吸道合胞病毒（RSV）的病例。患儿出生第一天即需要接受被动吸氧治疗，后因呼吸功能不全改为经鼻持续气道正压通气（nCPAP）治疗。随着患儿呼吸窘迫加重，对其进行气管插管。入院第二天，通过 RT-PCR 检测发现患儿鼻咽拭子中存在 H1N1 和 RSV。患儿被隔离，并接受奥司他韦和经验性抗生素治疗，病情得到改善。与患儿同时住在分娩后病房的其他新生儿因鼻咽拭子检测结果为阴性而未接受奥司他韦预防性治疗。患儿父母否认在分娩后 14 天内出现流感样症状，这提示患儿可能通过胎盘感染，或其父母为无症状感染者。总之，本报告证实了新生儿中存在病毒混合感染的可能性，这提醒我们在诊断中应考虑一组呼吸道病毒。新生儿流感的症状可能不典型，包括无发热病程。在流感新生儿中使用奥司他韦治疗似乎是一种有效的治疗措施。
