title: Atypical Presentations of Respiratory Syncytial Virus Infection: Case Series.
abstract: The respiratory syncytial virus (RSV) usually causes a lower respiratory tract infection in affected patients. RSV has also been infrequently linked to extrapulmonary diseases in children. We report four children who had unusually severe clinical manifestations of RSV infections requiring critical care admission. These patients presented to the Royal Hospital, Muscat, Oman, in December 2013 with acute necrotising encephalopathy (ANE), acute fulminant hepatic failure with encephalopathy, pneumatoceles and croup. A unique presentation of ANE has not previously been reported in association with an RSV infection. All patients had a positive outcome and recovered fully with supportive management.
authors.affiliation: Department of Paediatric Infectious Diseases, Royal Hospital, Muscat, Oman.
authors.forename: Nawal
authors.initials: N
authors.lastname: Al-Maskari
authors.affiliation: Department of Microbiology, Royal Hospital, Muscat, Oman.
authors.forename: Jalila
authors.initials: J
authors.lastname: Mohsin
authors.affiliation: Department of Paediatric Infectious Diseases, Royal Hospital, Muscat, Oman.
authors.forename: Amal
authors.initials: A
authors.lastname: Al-Maani
authors.affiliation: Department of Child Health, Royal Hospital, Muscat, Oman.
authors.forename: Nabil
authors.initials: N
authors.lastname: Al-Macki
authors.affiliation: Department of Paediatric Infectious Diseases, Royal Hospital, Muscat, Oman.
authors.forename: Suad
authors.initials: S
authors.lastname: Al-Ismaili
keywords: Case Series; Croup; Encephalitis; Epidemiology; Hepatitis; Oman; Respiratory Syncytial Virus Infections