Pneumococcal septic shock after neonatal respiratory syncytial virus bronchiolitis: A case report and literature review

Pneumococcal septic shock after neonatal respiratory syncytial virus bronchiolitis: A case report and literature review

Authors

  • Antonella Di Caprio Scuola di Specializzazione in Pediatria, Università di Modena e Reggio Emilia, 41124 Modena, Italy
  • Elena Coccolini Terapia Intensiva Pediatrica e Neonatale, Ospedale M. Bufalini, 47521 Cesena, Italy;
  • Paola Zagni Terapia Intensiva Neonatale, Ospedale Fatebenefratelli P.O. Macedonio Melloni, 20129 Milano, Italy;
  • Eleonora Vaccina Scuola di Specializzazione in Pediatria, Università di Modena e Reggio Emilia, 41124 Modena, Italy
  • Laura Lucaccioni UO di Pediatria, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, AOU Policlinico di Modena, Modena
  • Licia Lugli UO di Terapia Intensiva Neonatale, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, AOU Policlinico di Modena, Modena
  • Lorenzo Iughetti UO di Pediatria, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, AOU Policlinico di Modena, Modena
  • Alberto Berardi UO di Terapia Intensiva Neonatale, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, AOU Policlinico di Modena, Modena

Keywords:

Respiratory syncytial virus, Bronchiolitis, Streptococcus pneumoniae, Newborn, Antibiotic therapy, Case report

Abstract

Background: Bronchiolitis is a common cause of hospitalisation of infants less than a year old, with most infants recovering without complications. Respiratory syncytial virus (RSV) is a leading cause of bronchiolitis. Antimicrobial stewardship programmes do not recommend antibiotics for viral infections in neonates unless documented evidence of secondary bacterial infection is present. Case report: We present the case of a 7-day-old infant admitted to hospital with chest retractions and fever. The baby was hospitalised, empirical antibiotic therapy was administered, and non-invasive ventilation was started. When the viral aetiology was identified and clinical conditions improved, antibiotics were discontinued. However, after 48 hours, the newborn's condition worsened because of pneumococcal septic shock. Intravenous fluids, catecholamine support, and wide-spectrum antibiotics were administered. Non-invasive ventilation was re-started and continued until the full recovery. Conclusions: There is increasing evidence that RSV and S. pneumoniae co-infect and interact with each other, thus increasing respiratory diseases' severity. We provide a brief overview of the main international guidelines for managing bronchiolitis. Guidelines suggest avoidance of antibiotics use when the diagnosis of viral bronchiolitis is confirmed. We discuss the uncertainties regarding antibiotic use, especially in younger infants, who are more exposed to risks of bacterial superinfection.

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Published

30-04-2021

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Section

Case Reports: Pediatrics and Neonatology

How to Cite

1.
Di Caprio A, Coccolini E, Zagni P, Vaccina E, Lucaccioni L, Lugli L, et al. Pneumococcal septic shock after neonatal respiratory syncytial virus bronchiolitis: A case report and literature review. Acta Biomed [Internet]. 2021 Apr. 30 [cited 2024 Jul. 12];92(S1):e2021111. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/11209