Necrotizing Enterocolitis as a Rare Complication of Severe RSV Bronchiolitis in a Term Neonate: A Case Report With Narrative Review.
Paulo Sérgio Lucas da Silva, Emerson Yukio Kubo, Marcelo Cunio Machado Fonseca
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Case in brief
A previously healthy, full-term 24-day-old neonate was admitted with severe respiratory syncytial virus (RSV) bronchiolitis. The infant then developed abdominal distension, metabolic acidosis, and septic shock; imaging showed advanced necrotizing enterocolitis (NEC). The condition progressed despite intensive medical and surgical management, and the neonate died. The report describes NEC arising during severe RSV illness in a term infant without known risk factors, while noting that the relationship between RSV and NEC is uncertain.
What made this case unusual
Advanced NEC developed in a previously healthy, full-term neonate without known risk factors during severe RSV bronchiolitis, an uncommon association described in case reports and small series.
Diagnostic / clinical pearl
In severe RSV bronchiolitis, new abdominal distension or unexplained hemodynamic instability should prompt consideration of gastrointestinal complications, including NEC.