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• W4311542947 abstract "Introduction: Human Rhinovirus (HRV) is one of the most common pathogens associated with respiratory tract infections, otitis media, and sinusitis. Most cases of HRV are self-limiting and occur in children. We report a case of an adult who presented in respiratory distress and shock in the setting of one week of upper respiratory symptoms. He was found to be HRV positive with a pericardial effusion requiring drainage. Description: A 65-year-old male presented with a week of cough, congestion, dyspnea and found to be in respiratory distress with hypotension and tachycardia, but no hypoxia or fever. Labs revealed leukocytosis, elevated inflammatory markers, NT-proBNP, and lactate. His troponin, electrocardiogram, and chest x-ray were unremarkable. CT angiogram showed small pericardial effusion with enhancement of the pericardium and reflux of contrast into the inferior vena cava and hepatic veins. Despite treatment for septic shock, he required pressor support and ICU admission. Infectious workup was unremarkable except for positive rhinovirus PCR. Due to a lack of improvement, he went for CT-guided pericardiocentesis. Pericardial fluid showed many white blood and inflammatory cells and sterile culture. His shock resolved post-procedure and echocardiography showed improvement in the effusion. Discussion: Viral infections are the most common causes of pericardial effusions with adenoviruses, enteroviruses, cytomegaloviruses, and HIV being the most common4. HRV is a common cause of mild, self-limiting upper respiratory tract infections but rarely associated with severe infections including pericardial effusions. The development of newer, highly sensitive molecular techniques has led to the identification of a new species of rhinovirus, HRV-C, associated with severe lower respiratory tract infections and hemorrhagic pericarditis, especially in the elderly and immunocompromised1. There have been two cases of severe disseminated HRV-C infection with pericardial effusions reported in children but no cases in an immunocompetent adult, possibly due to underdiagnosis2,3. With no other etiologies identified, he was diagnosed with tamponade from HRV infection. This represents a rare manifestation of this disease. Clinicians should keep HRV in mind for cases of viral disease and resultant pericardial effusion." @default.
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• W4311542947 date "2022-12-15" @default.
• W4311542947 modified "2023-09-25" @default.
• W4311542947 title "385: PERICARDIAL EFFUSION AND TAMPONADE: AN UNCOMMON MANIFESTATION OF RHINOVIRUS" @default.
• W4311542947 doi "https://doi.org/10.1097/01.ccm.0000907268.54467.fd" @default.
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