Enterovirus-Human-Rhinovirus Infection Leading to Acute Respiratory Distress Syndrome: A Case Report

Area of Science:

• Medicine
• Virology
• Pulmonology

Background:

• Enterovirus-human-rhinovirus (EV-HRV) commonly causes upper respiratory infections and asthma exacerbations.
• While EV-HRV is linked to bronchitis and pneumonia, its role in severe acute respiratory distress syndrome (ARDS) is less defined.
• The potential for secondary EV-HRV infections following SARS-CoV-2 pneumonia requires further investigation.

Observation:

• A 67-year-old male with COPD and recent mild-to-moderate SARS-CoV-2 pneumonia was admitted with worsening respiratory failure.
• The patient required escalating supplemental oxygen and was diagnosed with EV-HRV infection.
• Chest imaging revealed extensive ground-glass opacities, consistent with ARDS.

Findings:

• A secondary EV-HRV infection was identified via respiratory pathogen panel in a patient recovering from SARS-CoV-2 pneumonia.
• The patient developed severe ARDS requiring high-flow nasal cannula oxygen support.
• Bacterial, fungal, and repeat SARS-CoV-2 testing were negative, suggesting EV-HRV as the primary cause of the ARDS.

Implications:

• This case suggests a potential causal link between recent SARS-CoV-2 infection and the development of severe ARDS secondary to EV-HRV.
• Highlights the importance of considering non-SARS-CoV-2 pathogens in patients with persistent or worsening respiratory symptoms post-COVID-19.
• Underscores the need for further research into the pathogenesis of secondary infections following viral respiratory illnesses.