Two cases of primary human parechovirus pneumonia in adults

Abstract

Human parechoviruses (HPeV) are mainly isolated from upper respiratory tract infection and gastroenteritis in children. HPeV has not been screened for in the past studies of community-acquired pneumonia (CAP) in adults, and its association with CAP is unknown. We present two cases that HPeV was detected by multiplex polymerase chain reaction for respiratory viruses using bronchoalveolar lavage fluid and diagnosed as pneumonia caused by HPeV.

Keywords: Bronchoalveolar lavage fluid; HPeV; PCR; Viral pneumonia; human parechovirus.

Fig. 1

Chest X-rays in case 1. Chest X-ray on admission (A) showed consolidation and reduced volume of the right lung. The greatest deterioration had occurred on day 8 (B), and by the time of discharge on day 18, they had improved but were still somewhat present (C). The reduced volume of the right lung has remained after two years (D).

Fig. 2

Chest computed tomography (CT) in case 1. Chest CT on admission showed bilateral consolidation (right dominant), ground-glass opacities (GGOs) around the consolidation, and air-bronchogram accompanying traction bronchiectasis within the consolidation. The GGOs in part showed non-segmental distribution.

Fig. 3

Chest X-rays in case 2. Chest X-ray on admission (A) showed nodular consolidation on both sides of the lung that had almost resolved at day 8 (B).

Fig. 4

Chest computed tomography (CT) in case 2. Chest CT on admission showed patchy consolidation and GGOs along the bronchial vascular bundle in the upper and lower lobes of the left lung and upper segment of the right lower lobe. Traction bronchiectasis and volume reduction of the lungs were not observed.

Fig. 5

Histologic findings. Histologic findings from transbronchial lung biopsy in case 2 showed organization, swollen pneumocytes, and alveolar septal thickening with inflammatory cells (hematoxylin and eosin staining; magnification, × 50).