Respiratory syncytial virus (RSV) pneumonia

Case contributed by Dr Yair Glick


Cough and fever.

Patient Data

Age: 40 days
Gender: Male

Right upper lobe (RUL) opacification with air bronchograms. Horizontal fissure concave towards RUL as sign of partial RUL atelectasis, most probably due to occluded bronchus.
Alveolar/interstitial-alveolar infiltrates with air bronchograms throughout left lung, more pronounced in the upper zone.

Case Discussion

Normal pregnancy and birth. Born at 42 weeks, birth weight 3800 g.
Ventricular septal defect (VSD) diagnosed postnatally.
Normal development, fully vaccinated.
Cough starting on the day before admission, fever starting on the day of admission.

Nasal swab positive for respiratory syncytial virus (RSV).

Viral lung infections commonly manifest as peribronchial cuffing and interstitial infiltrates. In this case, however, RSV pneumonia has a predominantly alveolar pattern. The RUL atelectasis was reported to the treating pediatrician, which prompted treatment with respiratory physical therapy.

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