Ebola virus disease complicated with viral interstitial pneumonia: a case report

BMC Infectious Diseases

Case Report

Nicola Magrini¹  Mario Antonini²  Nicola Petrosillo²  Maria Rosaria Capobianchi²  Antonino Di Caro²  Emanuele Nicastri²  Simone Lanini²  Giuseppe Ippolito²  Vincenzo Puro²  Francesco Nicola Lauria²  Nakono Shindo³  Gary P. Kobinger⁴ 

[1] Essential Medicines and Health Products Department, World Health Organization, Geneva, Switzerland;National Institute for Infectious Diseases Lazzaro Spallanzani-INMI IRCCS, Rome, Italy;Pandemic and Epidemic Diseases Department, World Health Organization, Geneva, Switzerland;Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada;

关键词: Hemorrhagic fever;    Ebola;    Pneumonia, viral;    Malaria, vivax;    Immunization, passive;    Antibodies, monoclonal;    Favipiravir;    Fluid therapy;    Life support care;    Hospitals, isolation;   

DOI  :  10.1186/s12879-015-1169-4

 received in 2015-06-09, accepted in 2015-09-30,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn the current Ebola epidemic in Western Africa, many healthcare workers have become infected. Some of these have been medically evacuated to hospitals in Europe and the USA. These clinical experiences provide unique insights into the course of Ebola virus disease under optimized condition within high level isolation units.Case presentationA 50-year-old Caucasian male physician contracted Ebola virus diseases in Sierra Leone and was medically evacuated to Italy. Few days after the admission the course of the illness was characterized by severe gastro-intestinal symptoms followed by respiratory failure, accompanied by pulmonary infiltration and high Ebola viral load in the bronchial aspirate and Plasmodium vivax co-infection. The patient received experimental antiviral therapy with favipiravir, convalescent plasma and ZMAb. Ebola viral load started to steadily decrease in the blood after ZMAb administration and became undetectable by day 19 after admission, while it persisted longer in urine samples. No temporal association was observed between viral load decay in plasma and administration of favipiravir. The patient completely recovered and was discharged 39 days after admission.ConclusionsThis is the first case of Ebola-related interstitial pneumonia documented by molecular testing of lung fluid specimens. This reports underlines the pivotal role of fluid replacement and advanced life support with mechanical ventilation in the management of patients with Ebola virus diseases respiratory failure. Beside our finding indicates a close temporal association between administration of cZMAb and Ebola virus clearance from blood.

【 授权许可】

CC BY   
© Petrosillo et al. 2015