Allergy Asthma Respir Dis.  2015 Nov;3(6):456-460. 10.4168/aard.2015.3.6.456.

Life-threatening human metapneumovirus pneumonia requiring extracorporeal membrane oxygenation in a 26-month-old child

• Choi SH
• Yoon SH
• Sol IS
• Kim MJ
• Kim YH
• Shin HJ
• Kim KW
• Sohn MH
• Kim KE

• KMID: 2218637
• DOI: http://doi.org/10.4168/aard.2015.3.6.456

Abstract

We present the first case report of a child with human metapneumovirus (hMPV) pneumonia who survived by extracorporeal membrane oxygenation (ECMO) in Korea. A 26-month-old boy with a previous history of Lennox-Gastaut syndrome and delayed development suffered from respiratory failure after 4 days of fever, cough, and sputum. The boy underwent intubation and required ECMO application due to failure of conventional mechanical ventilation. He was on the ECMO support for 7 days. To our knowledge, this is the shortest period reported for ECMO application among successfully treated patients with hMPV infection accompanied by acute respiratory distress syndrome. This case highlights 2 clinical implications: the potentially fatal causative role of hMPV in respiratory failure in a pediatric population and the timely utilization of ECMO.

Keyword

Human metapneumovirus; Child; Acute respiratory distress syndrome; Extracorporeal membrane oxygenations

MeSH Terms

Child*
Child, Preschool*
Cough
Extracorporeal Membrane Oxygenation*
Fever
Humans*
Intubation
Korea
Male
Metapneumovirus*
Pneumonia*
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Sputum

Figure

• 

  Fig. 1 (A) Four days after extracorporeal membrane oxygenation (ECMO) application, haziness on both lungs was improving. (B) Aeration in both lungs was increasing 1 hour before weaning ECMO. (C) Consolidation in right upper lung was slightly decreasing 1 day after weaning ECMO.

• 

  Fig. 2 Combination of continuous renal replacement therapies (CRRT) and extracorporeal membrane oxygenation (ECMO) circuit. The CRRT circuits were connected to the ECMO venous circuit. The circled portion is the centrifugal pump of ECMO. The square portion is the membrane oxygenator of ECMO. The two arrows are showing the CRRT connections, which were located before the centrifugal pump of ECMO.

• 

  Fig. 3 (A) Four days after extracorporeal membrane oxygenation (ECMO) application, haziness on both lungs was improving. (B) Aeration in both lungs was increasing 1 hour before weaning ECMO. (C) Consolidation in right upper lung was slightly decreasing 1 day after weaning ECMO.

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