Atypical presentations of MERS-CoV infection in immunocompromised hosts

J Infect Chemother. 2017 Nov;23(11):769-773. doi: 10.1016/j.jiac.2017.04.004. Epub 2017 May 23.

Abstract

During the 2015 Korean MERS outbreak, we experienced atypical presentations of MERS-CoV infections in three immunocompromised hosts that warranted exceptional management. Case 1 showed delayed symptom development after a four-day asymptomatic period, Case 2 experienced a 20-day incubation period, and Case 3 exhibited persistent viral shedding without clinical deterioration. Recognizing these exceptions is extremely important in the management of MERS-CoV-exposed or -infected patients and for control of potential MERS outbreaks.

Keywords: Asymptomatic period; Corticosteroid; Immunocompromised host; Incubation period; Middle East respiratory syndrome coronavirus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Blood Component Transfusion
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / therapy
  • Coronavirus Infections / virology
  • Disease Outbreaks / prevention & control*
  • Fatal Outcome
  • Female
  • Glucocorticoids / therapeutic use
  • Hematologic Neoplasms / therapy
  • Humans
  • Immunocompromised Host*
  • Immunosuppression Therapy / adverse effects
  • Infectious Disease Incubation Period
  • Male
  • Middle Aged
  • Middle East Respiratory Syndrome Coronavirus / isolation & purification*
  • Middle East Respiratory Syndrome Coronavirus / physiology
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Republic of Korea / epidemiology
  • Reverse Transcriptase Polymerase Chain Reaction
  • Time Factors
  • Tomography, X-Ray Computed
  • Virus Shedding

Substances

  • Antiviral Agents
  • Glucocorticoids