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Fatal respiratory distress syndrome due to coronavirus infection in a child with severe combined immunodeficiency Aleksandra Szczawinska Poplonyk a Katarzyna Jonczyk Potoczna b Anna Breborowicz a Alicja Bartkowska Sniatkowska c Magdalena Figlerowicz d a Department of Pediatric Pneumonology Allergology and Clinical Immunology Poznan University of Medical Sciences b Department of Pediatric Radiology Poznan University of Medical Sciences c Department of Pediatric Anesthesiology and Intensive Care Poznan University of Medical Sciences d Department of Pediatric Neurology and Infectious Diseases Poznan University of Medical Sciences Poznan Poland Correspondence Aleksandra Szczawinska Poplonyk Department of Pediatric Pneumonology Allergology and Clinical Immunology Poznan University of Medical Sciences Szpitalna Street 27 33 60 572 Poznan Poland E mail ola pl klinikapad xmail sk5 am poznan pl Accepted 13 October 2012 Published Online 30 November 2012 Coronaviruses have been demonstrated to contribute substantially to respiratory tract infections among the child population Though infected children commonly present mild upper airway symptoms in high risk patients with underlying conditions particularly in immunocompromised children these pathogens may lead to severe lung infection and extrapulmonary disorders In this paper we provide the first report of the case of a 15 month old child with severe combined immunodeficiency and coronavirus HKU1 related pneumonia with fatal respiratory distress syndrome Keywords Coronavirus severe combined immunodeficiency pneumonia children Please cite this paper as Szczawinska Poplonyk et al 2013 Fatal respiratory distress syndrome due to coronavirus infection in a child with severe combined immunodeficiency Influenza and Other Respiratory Viruses 7 5 634 636 Introduction Severe combined immunodeficiency SCID is a genetically and clinically heterogeneous group of the most severe pri mary immunodeficiencies characterized by the absence of functional T lymphocytes resulting in profound impairment of the cellular and humoral adaptive immunity Depending on the genetic defect B lymphocytes and natural killer NK cells may be present or absent and this feature constitutes the basis for the classical division into T B SCID and T B SCID with further subdivisions into NK and NK dis orders 1 Respiratory tract infection is a common manifesta tion in children in question and may be present within the neonatal period or in early infancy Opportunistic pathogens may lead to rapidly progressive fatal interstitial pneumonitis accompanied by hyperinflation resulting from small airway obstruction or to persistent bronchiolitic presentation Apart from pyogenic bacteria such as Pseudomonas aeruginosa Stenotrophomonas spp Burkholderia spp as well as Mycobac teria and fungi in particular Pneumocystis jiroveci respira tory viruses like respiratory syncytial virus RSV adenovirus parainfluenza virus human metapneumovirus hMPV and other viruses cytomegalovirus CMV vari cella zoster virus VZV and Epstein Barr virus EBV are associated with severe pneumonia in SCID children 2 Human coronaviruses HCoV HCoV 229E and HCoV OC43 and related new strains HCoV NL63 and HCoV HKU1 identified after the epidemic outbreak of severe acquired respiratory syndrome SARS coronavirus are likely to be common respiratory viruses in otherwise healthy children and were not implicated in severe lung infections in immunocompromised patients thus far 3 In this report we present the case of a child with delayed onset SCID and fatal respiratory coronavirus infection Case presentation A 15 month old girl was referred to the University Hospital due to persistent fever and interstitial pneumonitis for the purposes of diagnosis and treatment She was the first child of young non consanguineous par ents born from the first pregnancy which was terminated in the 39th week of gestation using Cesarian section surgery because of condylomata acuminata due to human papilloma The institution to which the work should be attributed DOI 10 1111 irv 12059 Short Article 634 2012 John Wiley 170 561 571 2 Eslamy HK Newman B Pneumonia in normal and immunocompro mised children an overview and update Radiol Clin North Am 2011 49 895 920 3 Kahn JS The widening scope of coronaviruses Curr Opin Pediatr 2006 18 42 47 4 Principi N Bosis S Esposito S Effects of coronavirus infections in children Emerg Infect Dis 2010 16 183 188 5 Ebihara T Endo R Ma X Ishiguro N Kikuta H Detection of human coronavirus NL63 in young children with bronchiolitis J Med Virol 2005 75 463 465 6 Vabret A Mourez T Dina J et al Human coronavirus NL63 France Emerg Infect Dis 2005 11 1225 1229 7 Shao X Guo X Esper F Weibel C Kahn J Seroepidemiology of group 1 human coronaviruses in children J Clin Virol 2007 40 207 213 8 Kuypers J Martin ET Heugel J Wright N Morrow R Englund JA Clinical disease in children associated with newly described corona virus subtypes Pediatrics 2007 119 e70 e76 9 Esper F Shapiro ED Weibel C Ferguson D Landry ML Kahn JS Association between a novel human coronavirus and Kawasaki dis ease J Infect Dis 2005 191 499 502 Szczawinska Poplonyk et al 636 2012 John Wiley Sons Ltd