Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Therapy of Aerosolized Ribavirin in a Leukemia Infant with RSV Infection

항암치료 중 RSV에 감염된 백혈병 영아에서의 리바비린 흡입치료 1례

  • Kwon, Hyo Jin (Department of Pediatrics, College of Medicine, Korea University) ;
  • Oh, Myung Jin (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jae Wook (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Chung, Nak Gyun (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Cho, Bin (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hack Ki (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kang, Jin Han (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 권효진 (고려대학교 의과대학 소아과학교실) ;
  • 오명진 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이재욱 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정낙균 (가톨릭대학교 의과대학 소아과학교실) ;
  • 조빈 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김학기 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실)
  • Received : 2012.04.19
  • Accepted : 2012.06.11
  • Published : 2012.12.25
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Abstract

Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infection in infants. Life-threatening RSV infection is often reported in young children and immunocompromised hosts. Since there is no report on ribavirin therapy for RSV pneumonia in pediatric cancer patients in Korea, we report one case of RSV pneumonia that developed in an infant with acute lymphoblastic leukemia (ALL). Despite administration of oral ribavirin and intravenous immunoglobulin, the patient's respiratory distress worsened and admission to an intensive care unit was necessary. Chest x-ray showed multifocal consolidation, pneumothorax, and pneumomediastinum. Treatment with aerosolized ribavirin led to significant clinical improvement. The role of aerosolized ribavirin is still controversial, but it might have a therapeutic potential for severe RSV pneumonia in children with leukemia.

RSV는 2세 미만의 소아에서 급성 하기도 감염으로 인한 입원의 주원인이다. 특히 미숙아, 선천성 심폐질환, 면역결핍이 동반된 경우 주요 위험군으로 알려져 있다. 고위험군의 소아에서 중증 RSV 감염의 경우 리바비린 흡입요법이 허가가 되어 있으나 고비용, 안전성 등의 문제로 국내 임상에서의 사용은 매우 제한적인 실정이다. 저자들은 8개월 여환이 급성 림프구성 백혈병으로 관해유도요법 항암치료 중 발생한 RSV 폐렴으로 기흉, 기종격동, 호흡부전이 동반된 중증 감염을 경험하였다. 정맥용 면역글로불린, 경구 리바비린 투여에 반응이 없어 리바비린 흡입 치료를 시행하였고, 이후 임상적 호전을 경험하였기에 보고하는 바이다.

Keywords

References

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