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Possible respiratory syncytial virus infection presenting as diffuse alveolar hemorrhage in an elderly treated with systemic corticosteroid: A case report

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Abstract
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Introduction: Respiratory syncytial virus infection is gaining interest in the elderly due to its growing morbidity and mortality. We present a Case of respiratory syncytial virus infection presenting as diffuse alveolar hemorrhage that was highly responsive to systemic corticosteroid in an elderly patient.

Case presentation: An 82-year old man was admitted to the intensive care unit with worsening hypoxic respiratory failure. Chest radiograph showed non-homogeneous air space opacities. Bronchoalveolar lavage showed a finding of alveolar hemorrhage. The diagnosis of diffuse alveolar hemorrhage was made and high-dose systemic corticosteroid was given. However, concomitant respiratory syncytial virus infection was later confirmed. Therefore, ribavirin and human immunoglobulin were added. During the course of his treatment, the steroid was stopped and restarted. Interestingly, the clinical course was highly responsive to systemic corticosteroid.

Conclusion: It appears that diffuse alveolar hemorrhage in this patient may have been due to an immunological process caused by respiratory syncytial virus. Therefore, corticosteroid therapy was highly effective in improving the patient's hemoptysis and hypoxic respiratory failure. We suggest that further studies are required on the use of steroid in this subset of patients with respiratory syncytial virus lower respiratory tract infection.

Keywords: Case report; Corticosteroid; Diffuse alveolar hemorrhage; Respiratory syncytial viruses.
Author(s)
고윤석Junho KangKyung Hun Nam
Issued Date
2021
Type
Article
Keyword
Case reportCorticosteroidDiffuse alveolar hemorrhageRespiratory syncytial viruses
DOI
10.1016/j.rmcr.2021.101399
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7099
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_d11d280d8d5a43b8b82da3a569f51e22&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Possible%20respiratory%20syncytial%20virus%20infection%20presenting%20as%20diffuse%20alveolar%20hemorrhage%20in%20an%20elderly%20treated%20with%20systemic%20corticosteroid:%20A%20case%20report&offset=0&pcAvailability=true
Publisher
RESPIRATORY MEDICINE
Location
영국
Language
영어
ISSN
0954-6111
Citation Volume
33
Citation Number
0
Citation Start Page
101399
Citation End Page
101399
Appears in Collections:
Medicine > Medicine
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