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Adenovirus pneumonia complicated with acute respiratory distress syndrome: a case report

Ka-Ho Hung1, Lung-Huang Lin

  • 1From the Department of Pediatrics (K-HH, L-HL), Cathay General Hospital, Taipei; and School of Medicine (L-HL), Fu-Jen Catholic University, New Taipei City, Taiwan.

Medicine
|May 22, 2015
PubMed

Insights

Severe adenovirus pneumonia in children can cause acute respiratory distress syndrome (ARDS). Early extracorporeal membrane oxygenation (ECMO) with high-frequency oscillatory ventilation (HFOV) can be life-saving for pediatric ARDS patients.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Respiratory medicine

Background:

  • Severe adenovirus infection in children can lead to acute respiratory distress syndrome (ARDS) and respiratory failure.
  • Mechanical ventilation or extracorporeal life support (ECLS) may be required for prolonged periods.
  • Early extracorporeal membrane oxygenation (ECMO) intervention is recommended for pediatric ARDS patients meeting specific criteria.

Observation:

  • A 9-month-old boy with adenovirus pneumonia (serotype 7 confirmed) rapidly progressed to ARDS.
  • Conventional ARDS therapies were ineffective.
  • Chest X-rays showed progressive bilateral lung infiltrations and pleural effusions over 11 days.

Findings:

  • ECMO combined with high-frequency oscillatory ventilation (HFOV) was initiated for 9 days.
  • Gradual improvement in lung expansion was observed on chest X-rays.
  • The patient was discharged after 38 days, with outpatient follow-up for post-ECMO and adenovirus sequelae.

Implications:

  • Adenovirus pneumonia can cause significant pulmonary morbidity and respiratory failure in children.
  • The combination of HFOV for lung recruitment and ECMO for lung rest offers a viable therapeutic strategy for severe pediatric ARDS.
  • This case highlights the potential benefit of early ECMO and HFOV in managing severe adenovirus-induced ARDS in children.

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