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Case Reports
. 2024 Nov 3;16(11):e72949.
doi: 10.7759/cureus.72949. eCollection 2024 Nov.

A Case of Triple Respiratory Coinfection: COVID-19, Enterovirus, and Parainfluenza

Muhammad H Bangash  1 , Shehar B Awais  1 , Chaudhary A Cheema  1 , Andrew J Luker  2 , Steven Prado  3 , Abdul Waheed  4   5
Affiliations
Case Reports

A Case of Triple Respiratory Coinfection: COVID-19, Enterovirus, and Parainfluenza

Muhammad H Bangash et al. Cureus. .

Abstract

We report a case of a 34-year-old female who presented to the emergency department with fever, nausea, vomiting, and diarrhea following a suspected foodborne illness. She tested positive for COVID-19, human parainfluenza virus type 4, and enterovirus/rhinovirus in the hospital. She subsequently developed hypoxia, hypotension, and sepsis. Blood work revealed leukocytosis and elevated inflammatory markers. Imaging of her abdomen showed fluid-filled bowel loops suggesting acute gastroenteritis and colitis of infectious or inflammatory etiology. She was initially treated with antibiotics for a suspected bacterial infection. However, her cultures resulted negative and her symptoms slowly improved with supportive care including probiotics and a low-fat diet. Due to her persistent shortness of breath related to her COVID-19 infection, she was started on a course of oral prednisone due to the anti-inflammatory effects of steroids. She was discharged home in stable condition with close outpatient follow-up. This study highlights the clinical challenges of managing multiple viral infections, particularly with concurrent COVID-19.

Keywords: coinfection; covid-19; enterovirus; parainfluenza; superinfection.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Review Board of WellSpan Health issued approval Exempt. Written informed consent was taken from the patient. WellSpan Health IRB does not review singular cases. Singular cases are exempt from IRB approval requirements. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CT abdomen/pelvis on day 1 of admission showing bowel loops with air-fluid levels and colonic fluid accumulation (indicated by the red line marking A).
Figure 2
Figure 2. CT abdomen/pelvis with contrast showing fluid-filled bowel loops and colonic fluid (indicated by the red line marking B).
See this image and copyright information in PMC

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