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Atypical Presentations of Respiratory Syncytial Virus Infection: Case Series

Nawal Al-Maskari1, Jalila Mohsin2, Amal Al-Maani1

  • 1Department of Paediatric Infectious Diseases, Royal Hospital, Muscat, Oman.

Sultan Qaboos University Medical Journal
|February 25, 2016
PubMed

Insights

Respiratory syncytial virus (RSV) can cause severe neurological and liver complications in children, including acute necrotising encephalopathy. This report details four critical cases of RSV infection with unusual extrapulmonary manifestations and their full recovery.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neurology

Background:

  • Respiratory syncytial virus (RSV) commonly causes lower respiratory tract infections.
  • Extrapulmonary manifestations of RSV in children are infrequently reported.
  • Severe RSV cases can necessitate critical care admission.

Purpose of the Study:

  • To report a unique cluster of severe RSV infections in children.
  • To highlight unusual extrapulmonary complications associated with RSV.
  • To describe the clinical presentation and outcomes of these severe cases.

Main Methods:

  • Retrospective case series of four children admitted to the Royal Hospital, Muscat, Oman.
  • Review of clinical data for patients presenting in December 2013 with severe RSV manifestations.
  • Documentation of presenting symptoms, diagnostic findings, and management.

Main Results:

  • Four children presented with severe RSV infections requiring critical care.
  • Unusual manifestations included acute necrotising encephalopathy (ANE), acute fulminant hepatic failure with encephalopathy, pneumatoceles, and croup.
  • ANE associated with RSV infection is a unique presentation.
  • All patients experienced a positive outcome with supportive care.

Conclusions:

  • RSV can present with severe and unusual extrapulmonary complications in children.
  • Acute necrotising encephalopathy is a newly identified potential complication of RSV infection.
  • Prompt supportive management can lead to full recovery even in severe RSV cases.

Keywords:
Case SeriesCroupEncephalitisEpidemiologyHepatitisOmanRespiratory Syncytial Virus Infections

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