A pediatric patient with interstitial pneumonia due to enterovirus D68.
Enterovirus D68 (EV-D68) infection is associated with upper and lower respiratory tract symptoms such as fever, cough, and wheezing. Pediatric patients with EV-D68 infection easily develop more severe respiratory complications compared to patients infected with other species of enterovirus, and consequently, have a higher rate of hospitalization and admission to intensive care units. Therefore, the clinical picture of respiratory complications associated with EV-D68 infection needs to be elucidated. Here, we report a 4-year-old girl of EV-D68 infection that required artificial respiration management within 24 h from the onset of cold symptoms. The patient was diagnosed with interstitial pneumonia on the basis of chest imaging findings with patchy, funicular and frosted glassy shadows, increased blood markers of surfactant protein-A, surfactant protein-D and sialylated carbohydrate antigen KL-6, and increased neutrophils and lymphocytes in the bronchoalveolar lavage. Steroids showed a remarkable effect in her treatment. Further investigations are needed to confirm the efficacy of steroids for interstitial pneumonia due to EV-D68 infection. As rapid deterioration of respiratory status is observed in EV-D68 infection, the possibility of interstitial pneumonia may be considered.
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Masaaki
M
Matsumoto
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Hiroyuki
H
Awano
Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Consumer Sciences, Kobe, Japan.
Miki
M
Ogi
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Kazumi
K
Tomioka
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Ai
A
Unzaki
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Masahiro
M
Nishiyama
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Daisaku
D
Toyoshima
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Mariko
M
Taniguchi-Ikeda
Kobe Children's Primary Emergency Medical Center, Kobe, Japan.
Akihito
A
Ishida
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Hiroaki
H
Nagase
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: ichim@med.kobe-u.ac.jp.
Ichiro
I
Morioka
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Kazumoto
K
Iijima
D015415:Biomarkers / Q000097:blood; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis; D002675:Child, Preschool; D030016:Enterovirus D, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000821:virology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000821:virology*; D008775:Methylprednisolone / Q000627:therapeutic use*; D018396:Mucin-1 / Q000097:blood; D011024:Pneumonia, Viral / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000821:virology*; D016133:Polymerase Chain Reaction; D037662:Pulmonary Surfactant-Associated Protein A / Q000097:blood; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood; D012121:Respiration, Artificial; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D005938:Glucocorticoids; C060192:MUC1 protein, human; D018396:Mucin-1; D037662:Pulmonary Surfactant-Associated Protein A; D037663:Pulmonary Surfactant-Associated Protein D; D002097:C-Reactive Protein; D008775:Methylprednisolone
Child; Enterovirus D68; Intensive care unit; Interstitial pneumonia; Steroid