Chest Infections: Fellow Case Report Slide: Chest Infections III |

Human Metapneumovirus: A Rare Case of Adult Pneumonitis FREE TO VIEW

Hammad Arshad, MD; Meilin Young, MD; Rajashekar Adurty, MD
Author and Funding Information

Allegheny General Hospital, Pittsburgh, PA

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):139A. doi:10.1016/j.chest.2016.08.148
Text Size: A A A
Published online

SESSION TITLE: Fellow Case Report Slide: Chest Infections III

SESSION TYPE: Affiliate Case Report Slide

PRESENTED ON: Tuesday, October 25, 2016 at 04:30 PM - 05:30 PM

INTRODUCTION: Although Human Metapneumovirus (hMPV) is primarily known to cause respiratory tract infections in children, it can rarely result in a severe respiratory illness in adults.

CASE PRESENTATION: A 33 year old male with past medical history of Down syndrome and asthma, presented to our facility with acute shortness of breath. Radiography revealed bilateral infiltrates and laboratory data was significant for leukocytosis, acute kidney injury and an elevated alveolar-arterial gradient.The patient required intubation for acute respiratory failure, but remained hypoxic necessitating initiation of a V-V ECMO. Bronchoscopy with bronchoalveolar lavage was performed. Bacterial,mycobacterial and fungal cultures were negative except viral cultures being positive for metapneumovirus.He was maintained on ECMO and ventilator support until his oxygen requirements gradually improved. He eventually had a tracheostomy and was discharged to a long term acute care facility after two month of hospital stay.

DISCUSSION: Human metapneumovirus (hMPV) is a recently described paramyxovirus associated with acute respiratory tract infection in persons of all age groups. Serologic studies have shown that the virus was prevalent for at least 50 years before identification. Like most respiratory viruses, hMPV primary infection occurs in early childhood.Reinfection in adulthood is not uncommon as the immunity is incomplete. The infection rates in adults,however appears to be lower and the infection is often clinically asymptomatic. It can still cause a severe respiratory disease in the elderly, immunocompromised and patients with underlying pulmonary or cardiac disease. Even though Ribavarin and IVIG have been shown to be effective in vitro the treatment generally is conservative. We now report a rare case of severe Metapneumoviral ARDS that was treated with VV ECMO and low tidal volume ventilation and had a favorable outcome.

CONCLUSIONS: Physicians should be vigilant for Human Metapneumovirus in adult patients with presumptive viral pneumonitis and risk factors, as early diagnosis and prompt escalation of respiratory support including ECMO can have a favorable outcome in such uncommon scenarios.

Reference #1: Panda S, Mohakud NK et al; Human Metapneumovirus: review of an important respiratory pathogen: International Journal of Infectious Diseases 25(2014)45-52

Reference #2: Haas LE, Thijsen SF et al; Human Metapneumovirus infections in ICU: a case report of three cases: Ann Intensive Care 2012;2:30

DISCLOSURE: The following authors have nothing to disclose: Hammad Arshad, Meilin Young, Rajashekar Adurty

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543