title: Sharing features of uncommon respiratory syncytial virus complications in infants.
abstract: We describe 4 nonconsecutive cases of infants admitted to Catholic University pediatric intensive care unit (PICU) because of complicated respiratory syncytial virus (RSV) infection during winter RSV outbreaks from the year 2000 to the year 2003. A hyponatremic epileptic status (as in the first case) has been reported by several authors as a rare RSV complication, potentially leading to death. The second infant developed a serious pulmonary edema after a subglottic obstruction (croup) associated with RSV infection. The remaining 2 infants developed a pneumothorax and subcutaneous emphysema while breathing spontaneously during an RSV bronchiolitis. In all infants, a full recovery and PICU discharge was achieved despite the need for mechanical ventilation in cases 1 and 2. Increased intrapleural negative pressure or its combination with hypoxia/hypercapnia has been suggested as the common factor possibly joining these different clinical pictures.
authors.affiliation: Pediatric Intensive Care Unit, Catholic University Medical School, Gemelli Hospital, Rome, Italy. marco.piastra@fastwebnet.it
authors.forename: Marco
authors.initials: M
authors.lastname: Piastra
authors.forename: Elena
authors.initials: E
authors.lastname: Caresta
authors.forename: Alessia
authors.initials: A
authors.lastname: Tempera
authors.forename: Arianna
authors.initials: A
authors.lastname: Langer
authors.forename: Giulia
authors.initials: G
authors.lastname: Zorzi
authors.forename: Silvia
authors.initials: S
authors.lastname: Pulitanò
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiaretti
authors.forename: Orazio
authors.initials: O
authors.lastname: Genovese
authors.forename: Luigi
authors.initials: L
authors.lastname: Viola
authors.forename: Luca
authors.initials: L
authors.lastname: Tortorolo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Polidori
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000150:complications*; D018113:Respiratory Syncytial Virus, Human