Severe Acute Respiratory Distress Syndrome Caused by Influenza B Virus in a Healthy Adult

流感病毒感染造成急性呼吸窘迫症候群常常會造成嚴重的併發症和很高的死亡率。大部分都是導因於A型流感病毒感染，而B型流感病毒大部分發生在小孩及健康的年輕成人。茲報告一位28歲健康男性感染B型流感並導致嚴重呼吸窘迫症候群。肺部病理切片顯示瀰漫性肺泡破壞。個案後來有接受抗病毒藥物oseltamivir及類固醇使用，但是血氧濃度並沒有明顯改善即使用了高頻震盪通氣和俯臥姿。後來這位病人有使用葉克膜改善血氧交換，但是發生嚴重的呼吸器相關肺炎和死亡。雖然B型流感病毒造成的呼吸窘迫症候群相對少見，健康成人若是有病毒性肺炎相關症狀仍須早期診斷及投藥。

關鍵字

B型流感病毒；呼吸窘迫症候群；開肺切片；高頻震盪通氣；俯臥姿；葉克膜

並列摘要

Primary influenza pneumonia is characterized by fever, cough, progressive dyspnea, and even respiratory failure in severe cases. Acute respiratory distress syndrome (ARDS) due to influenza pneumonia is rare and is associated with a very high mortality rate. Most reported cases of primary influenza pneumonia were caused by influenza A virus. There are rare reports of influenza B pneumonia, and most of the cases have occurred in children with underlying disease. We report a case of ARDS associated with influenza B pneumonia in a 28-year-old man without underlying disease. The pathologic features of the open lung biopsy were consistent with diffuse alveolar damage. The patient received oseltamivir and methylprednisolone therapy, but oxygenation deteriorated, and the patient was refractory to prone position ventilation and high frequency oscillatory ventilation. Extracorporeal membrane oxygenation was used as a life-sustaining modality, but the patient developed ventilator-associated pneumonia and died. Although rarely found, influenza B pneumonia could develop in adults without underlying disease and cause refractory ARDS.

並列關鍵字

acute respiratory distress syndrome ； influenza B virus ； open lung biopsy ； prone position ； high frequency oscillatory ventilation ； extracorporeal membrane oxygenation

國際替代計量

Severe Acute Respiratory Distress Syndrome Caused by Influenza B Virus in a Healthy Adult

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