Authors and affiliation (s):
Damini Kharb1, Muskan Kumari1, Parshant Pokhriyal1, Amarnath Pandey2, Anuj Nautiyal1,*
1Department of Pharmacy Practice, School of Pharmaceutical Sciences, Shri Guru Ram Rai University, Dehradun, Uttarakhand, INDIA.
2Department of Internal Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, INDIA.
ABSTRACT
Human Metapneumovirus (HMPV) is a significant viral pathogen known to cause severe respiratory infections, including pneumonia, Acute Respiratory Distress Syndrome (ARDS), and type-1 respiratory failure in adults. Early identification and multidisciplinary management are crucial, especially when associated with comorbid conditions like Iron Deficiency Anemia (IDA). To report a rare case of HMPV-induced severe viral pneumonia complicated by type-1 respiratory failure and ARDS in a 33-year-old female, highlighting the clinical pharmacist’s role in supportive care. A 33-year-old female presented with shortness of breath, chest pain, fever, and chills. Clinical and radiological evaluations revealed ARDS with type-1 respiratory failure. Laboratory parameters confirmed severe IDA (Hb 6.4 g/dL, ferritin 37.1 ng/mL), elevated CRP (275.84 mg/L), and ESR (86 mm/hr). ECG changes and elevated cardiac biomarkers indicated possible viral myocarditis. The patient tested positive for HMPV. Empirical therapy included antibiotics (piperacillin-tazobactam, azithromycin, cefuroxime), antivirals (oseltamivir), corticosteroids (prednisolone, budesonide), and supportive care including PRBC transfusions, oxygen, and nebulization. Clinical pharmacists supported dose monitoring, ADR prevention, and therapy optimization. The patient responded well to multidisciplinary treatment, with gradual normalization of oxygen saturation, decline in inflammatory markers, and clinical improvement. She was discharged in stable condition after successful resolution of respiratory symptoms. This case underscores the importance of early diagnosis, pharmacist-led multidisciplinary care, and individualized therapy in managing viral pneumonia complicated by ARDS. HMPV should be considered in the differential diagnosis of acute respiratory failure when bacterial causes are excluded.
Keywords: Respiratory Failure, Antibiotics, HMPV.