Severe human metapneumovirus pneumonia in a child with chronic illness.

摘要

A two-and-a-half-year-old Caucasian girl presented to her physician with a 3-day history of clear rhinorrhea and dry cough. She was diagnosed with sinusitis and given oral amoxicillin/clavulanic acid. By day 4, she developed watery diarrhea and fever up to 102.3°F. The patient's parents and grandmother manifested similar illness. The patient had received an influenza vaccination. The child was born at term and developed hydro-cephalus and swallowing difficulty because of type 1 Arnold Chiari malformation, patent ductus arteriosus and cardiomegaly. During the first year of life, she was initially tube fed and was hospitalized for multiple aspiration pneumonias. She underwent placement of a gas-trostomy button, fundoplication, and repair of intestinal malrotation. She also underwent a ventriculoperitoneal shunt placement, cervical decompression, patent ductus arteriosus closure with an Amplatzer device, and repair of a laryngeal cleft. She had a single bout of methicillin-resistant Staphylococcus aureus ventriculitis and a urinary tract infection. She required supplemental oxygen for bronchiectasis and was developmentally delayed.