A rare case of metapneumovirus-induced rhabdomyolysis and multi-organ dysfunction in a 4-year-old child

ABSTRACT

Human metapneumovirus (hMPV) is a common cause of acute respiratory tract infections in children. In immunocompetent individuals, the course of hMPV infection is usually benign and self-limiting. A developmentally normal, previously healthy 4-year-old girl presented with pneumonia and later developed rhabdomyolysis and multi-organ dysfunction syndrome (MODS) which was fatal. Extensive microbiological investigation for a possible viral aetiology was positive only for hMPV, thus making it the first reported case of hMPV infection-related rhabdomyolysis.

Abbreviations: ARDS, acute respiratory distress syndrome; CK, creatinine kinase; hMPV, human metapneumovirus; MODS, multi-organ dysfunction syndrome; RSV, respiratory syncytial virus

KEYWORDS:

• Metapneumovirus
• rhabdomyolysis
• multi-organ dysfunction
• respiratory virus
• hMPV
• acute kidney injury

Contributors

ACC, RB and DG managed the patient, reviewed the literature and drafted the manuscript. NP managed the patient and critically revised the manuscript. All authors contributed to reviewing the literature and drafting the manuscript and approved the final version of the manuscript.

Additional information

Notes on contributors

Aakash Chandran Chidambaram

Aakash Chandran Chidambaram is a junior resident doctor in the department of paediatrics pursuing his training in Paediatrics at Jawaharlal Institute of Post graduate Medical education and Research (JIPMER), Puducherry, India.

Rohit Bhowmick

Rohit Bhowmik has completed his sub speciality training in paediatric critical care in Jawaharlal Institute of Post graduate a medical education and research and is currently working as an Assistant professor of Paediatrics looking after the Paediatric Intensive Care unit (PICU) in Pondicherry Institute of Medical sciences, Puducherry, India.

Narayanan Parameswaran

Narayanan Parameswaran is a paediatric intensivist, with 15 years’ experience of working in paediatric critical care. His areas of interest include evidence informed medicine, patient safety and quality and mechanical ventilation. Currently he is working as a professor in the department of Paediatrics at the Jawaharlal Institute of Post graduate Medical education and Research (JIPMER), Puducherry, India.

Dhandapany Gunasekaran

Dhandapany Gunasekaran is a paediatrician, with special interest in nutrition and immunisation and has more than 20 years of academic experience. Currently he is working as a professor in the department of paediatrics at the Jawaharlal Institute of Post graduate Medical education and Research (JIPMER), Puducherry, India.