The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 5
A life-threatening respiratory syncytial virus infection: a previously healthy infant with bilateral spontaneous pneumothorax and acute respiratory distress syndrome
Divisions of 1Pediatric Critical Care, and 2Pediatric Infectious Diseases, Department of Pediatrics, Ankara University
Faculty of Medicine, Ankara, Turkey. E-mail: odek@ankara.edu.tr
Respiratory syncytial virus (RSV) is the leading cause of viral respiratory
tract infections in infants and young children. Although the course of RSV
infection is usually benign, a small proportion of infants require mechanical
ventilation for respiratory failure. We describe an eight-month-old previously
healthy female who developed bilateral pneumothorax and acute respiratory
distress syndrome (ARDS) secondary to RSV infection. Because of the severe
hypoxemia, three doses of surfactant were administered and prone positioning
was implemented for nine days. After a prolonged course of mechanical
ventilation, she was extubated at day 21 and discharged from the pediatric
intensive care unit four days later. We conclude that RSV infections can be
severe, and some patients may require mechanical ventilation. Supportive
therapies like surfactant replacement therapy and prone positioning can be
beneficial in patients with ARDS in whom severe hypoxemia persists despite
high levels of positive end-expiratory pressure (PEEP) and plateau pressures.
Keywords :
respiratory syncytial virus, pneumothorax, acute respiratory distress
syndrome, surfactant, prone positioning.