title: Enterovirus D68 Infection in an Adult.
abstract: The first confirmed US case of severe respiratory tract infection caused by enterovirus D68 in an adult occurred in a pregnant woman with no history of asthma in August 2014. Before she came to the hospital, she had a productive cough, headache, and increasing dyspnea. At the hospital, she was hypoxic and required admittance to the intensive care unit and management with noninvasive bilevel positive pressure assistance. Analysis of a nasopharyngeal swab sent to the Centers for Disease Control and Prevention for a viral respiratory panel of tests confirmed enterovirus D68 infection. She eventually had an uneventful vaginal delivery, was discharged without oxygen supplementation, and has resumed normal activities. This case suggests that pregnant women may be a sentinel group infected with this pathogen, similar to what has been described for influenza virus infection.
authors.affiliation: Nicholas S. Ward is an attending physician, Division of Pulmonary, Critical Care, and Sleep Medicine, Rhode Island Hospital, and an associate professor, Warren Alpert Medical School, Brown University, Providence, Rhode Island. Brenna L. Hughes is an associate professor, Warren Alpert Medical School, and director, Division of Maternal Fetal Medicine fellowship, Women and Infants Hospital, Providence, Rhode Island. Leonard A. Mermel is an attending physician, Division of Infectious Diseases, Rhode Island Hospital, and a professor, Warren Alpert Medical School, Brown University.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Ward
authors.affiliation: Nicholas S. Ward is an attending physician, Division of Pulmonary, Critical Care, and Sleep Medicine, Rhode Island Hospital, and an associate professor, Warren Alpert Medical School, Brown University, Providence, Rhode Island. Brenna L. Hughes is an associate professor, Warren Alpert Medical School, and director, Division of Maternal Fetal Medicine fellowship, Women and Infants Hospital, Providence, Rhode Island. Leonard A. Mermel is an attending physician, Division of Infectious Diseases, Rhode Island Hospital, and a professor, Warren Alpert Medical School, Brown University.
authors.forename: Brenna L
authors.initials: BL
authors.lastname: Hughes
authors.affiliation: Nicholas S. Ward is an attending physician, Division of Pulmonary, Critical Care, and Sleep Medicine, Rhode Island Hospital, and an associate professor, Warren Alpert Medical School, Brown University, Providence, Rhode Island. Brenna L. Hughes is an associate professor, Warren Alpert Medical School, and director, Division of Maternal Fetal Medicine fellowship, Women and Infants Hospital, Providence, Rhode Island. Leonard A. Mermel is an attending physician, Division of Infectious Diseases, Rhode Island Hospital, and a professor, Warren Alpert Medical School, Brown University. lmermel@lifespan.org.
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Mermel
mesh_terms: D000328:Adult; D000420:Albuterol / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods; D036861:Delivery, Obstetric; D030016:Enterovirus D, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging* / Q000628:therapy; D059285:Pregnancy, Twin; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D011239:Prednisolone; D000420:Albuterol