Parainfluenza pneumonia in severe combined immunodeficiency disease

摘要: IN PATIENTS with severe combined immune deficiency, death is often secondary to pneumonitis. Most reports refer Pneumocystis carinii or bacteria as the common pathogen, whereas viral infections are rarely described playing a major role in these patients. This paper describes two infants SCID who developed parainfluenza virus pneumonitis, ending respiratory failure and death. CASE REPORTS Patient 1. 9-week-old white girl was transferred Hospital for Sick Children evaluation following episodes of possible neonatal sepsis. Fever, poor feeding, lethargy were observed during first days life. All cultures negative and, after completing course antibiotics, she discharged. At five weeks age admitted treatment osteomyelitis. Laboratory investigations revealed abnormally low serum immunoglobulin levels impaired T-cell function, HSC evaluation. On admission found be less than third percentile both length weight. Physical examination an absence lymphoid tissue, hypertonia, multiple inflamed iv sites on head extremities. Immunologic confirmed humoral cellular deficiency profound hypogammaglobulinemia, 10% E-rosetring T-lymphocytes, absent proliferative responses phytohemagglutinin, concanavalin A, pokeweed mit0gen, allogeneic cells. Parenteral gamma globulin replacement begun. chest radiograph bilateral upper lobe consolidation. The initial nasopharyngeal aspirate