Acute rhabdomyolysis and delayed pericardial effusion in an Italian patient with Ebola virus disease: a case report

BMC Infect Dis. 2017 Aug 30;17(1):597. doi: 10.1186/s12879-017-2689-x.

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 10 days and indomethacin for 2 months. 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.

Keywords: Ebola Virus Disease; Pericardial effusion; Rhabdomyolysis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Amides / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Ebolavirus / immunology
  • Ebolavirus / pathogenicity
  • Health Personnel
  • Hemorrhagic Fever, Ebola / complications*
  • Hemorrhagic Fever, Ebola / drug therapy
  • Humans
  • Indomethacin / therapeutic use
  • Italy
  • Male
  • Pericardial Effusion / drug therapy*
  • Pericardial Effusion / etiology*
  • Pericardial Effusion / virology
  • Pyrazines / therapeutic use
  • Rhabdomyolysis / drug therapy*
  • Rhabdomyolysis / etiology*
  • Rhabdomyolysis / virology
  • Sierra Leone

Substances

  • Adrenal Cortex Hormones
  • Amides
  • Antibodies, Monoclonal
  • Pyrazines
  • favipiravir
  • Indomethacin