Parainfluenza virus pneumonia after lung transplantation: a case report and literature review

Abstract

Objective To explore the clinical characteristics, diagnosis, treatment and prognosis of parainfluenza virus (PIV) pneumonia after lung transplantation. Methods One case of PIV pneumonia after lung transplantation was retrospectively analyzed. The relevant domestic and foreign cases and literature review were summarized. Results The recipient underwent sequential bilateral lung transplantation for chronic obstructive pulmonary disease, bullae and respiratory failure. Donor lung was sourced from donation after cardiac death. Routine anti-rejection therapy was prescribed postoperatively. At 14 months, cough and shortness of breath lead to hospitalization for over 1 month. At 15 months, sputum/fungal smear and culture showed that nucleic acid of PIV was positive. The definite diagnosis was PIV pneumonia after lung transplantation. After ribavirin antiviral therapy, tracheal intubation and invasive ventilation, followed by imipenem plus doxycycline plus anti-infective therapy, ganciclovir antiviral therapy, repeated bronchoscopic sputum aspiration and lavage treatment, the patient's condition deteriorated and died from breathing failure and septic shock at 16 months. Conclusions Preventing PIV infection after lung transplantation is of vital importance. PCR is essential for a rapid detection of virus infection. However, there is no curative treatment of PIV infection. Specific parainfluenza immunoglobulin and DAS181 aerosol inhalation may be applied for future treatment of PIV infection in lung transplant recipients. Key words: Lung transplantation; Parainfluenza virus; Pneumonia