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Disseminated parainfluenza infection in a child with severe combined immunodeficiency
Insights
Severe combined immunodeficiency syndrome (SCIDS) infant experienced disseminated parainfluenza virus type 3 (PIV-3) infection. PIV-3 was identified in respiratory and unusual sites, including cerebrospinal fluid and pericardial fluid, during life and postmortem.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Severe combined immunodeficiency syndrome (SCIDS) impairs immune function, increasing susceptibility to infections.
- Parainfluenza virus type 3 (PIV-3) is a common respiratory pathogen, typically causing self-limiting illness in immunocompetent individuals.
Observation:
- An infant diagnosed with SCIDS presented with severe pneumonitis.
- During hospitalization, PIV-3 was detected in respiratory secretions and subsequently in unusual sites like pericardial fluid, cerebrospinal fluid (CSF), and white blood cells (WBCs).
- Postmortem examination revealed viral pancreatitis, with PIV-3 isolated from lung, brain, and pericardial fluid.
Findings:
- This case represents the first documented instance of disseminated PIV-3 infection identified during a patient's lifetime.
- The virus spread beyond the respiratory tract to multiple organs and bodily fluids.
Implications:
- The findings suggest that PIV-3 can cause severe, disseminated disease in infants with SCIDS.
- A potential mechanism for viral dissemination may involve a mutant fusion protein, enabling the virus to spread beyond its typical respiratory tropism.
- This case highlights the importance of considering PIV-3 in the differential diagnosis of severe infections in immunocompromised infants.
Abstract:
An 8-month-old male infant with severe combined immunodeficiency syndrome was admitted to the hospital with pneumonitis and, subsequently, died at 21 months of age. During his lengthy hospitalization, parainfluenza virus type 3 (PIV-3) was isolated from respiratory secretions and unusual sites, such as pericardial fluid, CSF, and WBCs. A postmortem examination showed apparent viral pancreatitis, and PIV-3 was isolated from the lung, brain, and pericardial fluid. To our knowledge, this is the first reported case of disseminated parainfluenza infection identified during life. We speculated that a mutant fusion protein may have been elaborated by the virus, allowing dissemination beyond the respiratory tract.