Abstract

A 22-year-old Asian woman presented with respiratory distress, cough, and wheezing for 1 week. Prior history included asthma and Turner syndrome. On presentation to the emergency department, the patient was hypotensive, tachycardic, tachypneic, with an oxyhemoglobin saturation in the mid 80% range while breathing ambient air. Chest radiograph revealed pulmonary vascular congestion and a left lower lobe infiltrate. Endotracheal intubation, mechanical ventilation, and vasopressors were initiated. Empiric therapy for community-acquired pneumonia was administered utilizing broad-spectrum intravenous antibiotics. Routine sputum culture was negative for pathogens. Nasopharyngeal swab submitted for multiplex amplified nucleic acid testing yielded enterovirus-human rhinovirus (EV-HRV). Thus, the diagnosis of EV-HRV pneumonia complicated by acute respiratory distress syndrome (ARDS) was established. Multiple attempts to wean from the ventilator were unsuccessful, and a tracheostomy was performed. This report highlights EV-HRV as a cause of severe ARDS and prolonged respiratory failure in adults.

Highlights

  • Enteroviruses are single-stranded RNA viruses of the picornavirus family that mainly affect the pediatric population

  • We report a young woman who developed acute respiratory distress syndrome (ARDS) secondary to enterovirus-human rhinovirus (EV-HRV) infection

  • ARDS is characterized by diffuse inflammation of the lungs leading to severe respiratory distress and hypoxemia refractory to oxygen therapy

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Summary

Introduction

Enteroviruses are single-stranded RNA viruses of the picornavirus family that mainly affect the pediatric population. It is one of the rare cause of acute respiratory distress syndrome (ARDS) in adults. The severity and the disease course varies widely.

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