Mazza Sebastiano, Ciccone Benedetta, D'Apolito Anna Maddalena, Petruccelli Caterina, Tedeschi Dalila, Ippedico Francesca, Lauriola Marianna, Ferrante Stefano Aniello, Baiardi Claudia, Calò Anna, Fortunato Francesca, Campanozzi Angelo
Dipartimento Donna e Bambino, Azienda Ospedaliera Universitaria Foggia, Foggia, Apulia, Italy.
Dipartimento di Scienze Mediche e Chirurgiche, Università Degli Studi di Foggia, Foggia, Apulia, Italy.
Case Rep Pediatr. 2025 Jul 21;2025:3334926. doi: 10.1155/crpe/3334926. eCollection 2025.
We present the case of a five-month-old late preterm infant who developed severe bronchiolitis caused by respiratory syncytial virus, requiring hospitalisation and high-flow nasal cannula support. This occurred 142 days after the infant received a single dose of nirsevimab as part of the regional immunisation campaign, administered on day three of life. The patient had no underlying conditions. PCR testing revealed RSV A and human rhinovirus co-infection. The infant improved with supportive care and was discharged in stable condition after 8 days. This case raises concerns about possible waning immunity near the end of the expected 150-day protection window of nirsevimab, particularly in infants immunised early in the RSV season. Additionally, co-infection with hRV may have contributed to disease severity. Although nirsevimab remains a highly effective preventive tool, this case highlights the potential for waning immunity near the end of the protection window and suggests that ongoing surveillance is essential to optimize immunization strategies, particularly in regions with prolonged RSV seasons.
我们报告了一例五个月大的晚期早产儿病例，该婴儿因呼吸道合胞病毒感染引发严重细支气管炎，需要住院治疗并接受高流量鼻导管支持。这一情况发生在婴儿作为地区免疫计划的一部分，于出生第三天接种单剂量尼塞韦单抗142天后。该患者无基础疾病。聚合酶链反应检测显示为呼吸道合胞病毒A与人类鼻病毒合并感染。婴儿通过支持性治疗后病情好转，8天后病情稳定出院。该病例引发了人们对于尼塞韦单抗预期150天保护期临近结束时可能出现免疫减弱的担忧，尤其是在呼吸道合胞病毒流行季早期接种疫苗的婴儿中。此外，与人类鼻病毒的合并感染可能加重了疾病的严重程度。尽管尼塞韦单抗仍然是一种高效的预防工具，但该病例凸显了保护期临近结束时免疫减弱的可能性，并表明持续监测对于优化免疫策略至关重要，特别是在呼吸道合胞病毒流行季较长的地区。
