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• W2894564656 abstract "SESSION TITLE: Chest Infections 2 SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/09/2018 01:15 PM - 02:15 PM INTRODUCTION: Human parainfluenza virus type 1 (HPIV-1) is primarily known for causing upper respiratory tract infections in adults and croup in children. Although rare, HPIVs have also been identified as a cause of community-acquired pneumonia (CAP) in adults. HPIV-induced acute respiratory distress syndrome (ARDS) is thought to be an extremely rare complication. CASE PRESENTATION: We present a case of HPIV-1-induced ARDS in a 31-year-old man with poorly controlled type II diabetes and medically complicated obesity (BMI 55.1). He presented with a 5-day history of cough, congestion, and dyspnea that progressed to severe hypoxemic respiratory failure requiring intubation and mechanical ventilation. His initial PaO2 to FiO2 ratio was 61. Laboratory studies were significant for leukocytosis (12,300 /L) and elevated C-reactive protein (138.8 mg/L). Chest x-ray demonstrated diffuse bilateral infiltrates. Computed tomography of the chest revealed diffuse bilateral dense consolidations. Bronchoscopy showed no evidence of alveolar hemorrhage. Bronchial alveolar lavage (BAL) and blood cultures were negative. BAL viral polymerase chain reaction (PCR) for adenovirus and influenza was negative. Nasal viral PCR studies were positive for parainfluenza virus type 1. Transthoracic echocardiogram revealed an ejection fraction of 60 percent without evidence of diastolic dysfunction. The patient was treated with lung protective ventilation and paralysis. Secondary to his body habitus, proning could not be safely accomplished. On hospital day 4, he was successfully extubated, and ultimately demonstrated complete recovery. DISCUSSION: ARDS is a rare complication of viral pneumonia. As new advancements in laboratory technologies continue to develop, specifically with viral real-time PCR, the incidence of viral-induced ARDS will likely increase, including identification of viruses that were previously believed to cause only mild disease. This is important in patient management, as quick and accurate diagnosis could potentially avoid unnecessary diagnostic and therapeutic interventions, although superimposed bacterial infections should always be ruled out. As long as no superimposed pathology is present, patients similar to the one presented here will have the best chance of improvement with standard supportive therapies. CONCLUSIONS: Parainfluenza virus can precipitate ARDS in susceptible hosts. Reference #1: Luyt CE, Combes A, Trouillet JL, Nieskowska A, Chastre J. Virus-induced acute respiratory distress syndrome: epidemiology, management, and outcome. La Presse Medicale. 2011;40(12):e561-e568. Reference #2: Jennings LC, Anderson TP, Beynon KA, et al. Incidence and characteristics of viral community-acquired pneumonia in adults. Thorax. 2008;63:42-48. Reference #3: Souf S. Recent advances in diagnostic testing for viral infections. Bioscience Horizons: The International Journal of Student Research. 2016; 9:1 DISCLOSURES: No relevant relationships by Alice Gallo De Moraes, source=Web Response No relevant relationships by Max Martin, source=Web Response No relevant relationships by Kelly Pennington, source=Web Response" @default.
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• W2894564656 date "2018-10-01" @default.
• W2894564656 modified "2023-09-25" @default.
• W2894564656 title "PARAINFLUENZA VIRUS TYPE 1-INDUCED ARDS" @default.
• W2894564656 doi "https://doi.org/10.1016/j.chest.2018.08.107" @default.
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