Background: During the 2013-2016 West Africa Ebola virus disease (EVD) epidemic, some EVD patients, mostly health care workers, were evacuated to Europe and the USA. Case presentation: In May 2015, a 37-year old male nurse contracted Ebola virus disease in Sierra Leone. After Ebola virus detection in plasma, he was medically-evacuated to Italy. At admission, rhabdomyolysis was clinically and laboratory-diagnosed and was treated with aggressive hydration, oral favipiravir and intravenous investigational monoclonal antibodies against Ebola virus. The recovery clinical phase was complicated by a febrile thrombocytopenic syndrome with pericardial effusion treated with corticosteroids for 10days and indomethacin for 2months. No evidence of recurrence is reported. Conclusions: A febrile thrombocytopenic syndrome with pericardial effusion during the recovery phase of EVD appears to be uncommon. Clinical improvement with corticosteroid treatment suggests that an immune-mediated mechanism contributed to the pericardial effusion.
Acute rhabdomyolysis and delayed pericardial effusion in an Italian patient with Ebola virus disease : a case report / E. Nicastri, A. Brucato, N. Petrosillo, G. Biava, T.M. Uyeki, G. Ippolito, N. Bevilacqua, E. Boumis, P. Chinello, S. Cicalini, A. Corpolongo, V. Galati, A. Mariano, S. Rosati, F. Taglietti, L. Vincenzi, M. Antonini, I. Caravella, G. Garotto, L. Marchioni, M. Maritti, P. Balestra, M. Ricottini, E.B. Rizzi, M.R. Capobianchi, A. di Caro, C. Castilletti, L. Bordi, E. Lalle, M. Biava, S. Meschi, D. Lapa, P. Marsella, F. Colavita, R. Chiappini, A. Mazzarelli, S. Quartu, C. Agrati, F. Carletti, F. Forbici, M.B. Valli, I. Abbate, A. Amendola, A.R. Garbuglia, M.G. Paglia, E. Bordi, D. Travaglini, A. Toffoletti, G. Battisti, A. Coppola, L. De Marchis, N. De Marco, P. Giacomini, F. Di Gianbattista, M. Guiducci, A. Marasco, A. Marzolini, A. Mercuri, P. Nieddu, S. Ondedei, M. Vescovo, G. Battisti, M. Liguori, F.N. Lauria, V. Puro, A. Russo, P. D'Aprile, A. Petrecchia, M. Gentile, S. Pittalis, L. Martini, F.M. Fusco, S. Lanini, A. Antinori, M. Cerimele, M. Branca. - In: BMC INFECTIOUS DISEASES. - ISSN 1471-2334. - 17:1(2017), pp. 597.1-597.4.
Acute rhabdomyolysis and delayed pericardial effusion in an Italian patient with Ebola virus disease : a case report
A. Brucato;
2017
Abstract
Background: During the 2013-2016 West Africa Ebola virus disease (EVD) epidemic, some EVD patients, mostly health care workers, were evacuated to Europe and the USA. Case presentation: In May 2015, a 37-year old male nurse contracted Ebola virus disease in Sierra Leone. After Ebola virus detection in plasma, he was medically-evacuated to Italy. At admission, rhabdomyolysis was clinically and laboratory-diagnosed and was treated with aggressive hydration, oral favipiravir and intravenous investigational monoclonal antibodies against Ebola virus. The recovery clinical phase was complicated by a febrile thrombocytopenic syndrome with pericardial effusion treated with corticosteroids for 10days and indomethacin for 2months. No evidence of recurrence is reported. Conclusions: A febrile thrombocytopenic syndrome with pericardial effusion during the recovery phase of EVD appears to be uncommon. Clinical improvement with corticosteroid treatment suggests that an immune-mediated mechanism contributed to the pericardial effusion.
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