Influenza A (H1N1) and Respiratory Syncytial Virus (RSV) Coinfection in a Newborn Child: A Case Report

Abstract

This paper presents a case of coinfection of influenza A virus (H1N1) and respiratory syncytial virus (RSV) in a male newborn. On the first day of life, the newborn required passive oxygen therapy, followed by respiratory support with nasal continuous positive airway pressure (nCPAP) due to respiratory insufficiency. As the newborn's respiratory effort was intensifying, he was intubated. In the second day of life, a nasopharyngeal swab was taken yielding the presence of H1N1 and RSV in the RT-PCR test. The child was isolated and given oseltamivir and empirical antibiotic therapy, which improved his condition. Other newborns who initially stayed with the sick child in the post-delivery room did not obtain oseltamivir prophylactically as their nasopharyngeal swabs were negative. The child's parents denied the occurrence of influenza-like symptoms within 14 days of delivery, which suggests a transplacental transmission of the child's infection or asymptomatic course of infection in the parents. In conclusion, this report confirms the possibility of viral coinfections in newborns, which points attention to considering a panel of respiratory viruses in the diagnostics. Symptoms of influenza in newborns may be atypical, including a fever-free course. Oseltamivir treatment in newborns with influenza seems an effective therapeutic measure.

Keywords: Coinfection; Influenza; Nasopharyngeal swab; Newborn; Respiratory syncytial virus.