Successful treatment of orthopneumovirus infection in a patient with primary diffuse B-cell large cell lymphoma of the central nervous system

Introduction . Oncohematological patients are a vulnerable category in relation to orthopneumovirus (OPV), which affects cells of the respiratory epithelium and lung tissue. Aim: to present a clinical observation of the identification of OPV and successful ribavirin treatment of a patient with Diffuse large B-cell lymphoma (DLBCL) and acute respiratory failure (ARF) due to viral pneumonia. Main findings. Patient S., 56 years old, was diagnosed with DLBCL of the central nervous system. After the first course of chemotherapy, he developed acute kidney injury, fever, and bilateral pneumonia with ARF. DNA of Pneumocystis jirovecii was found in bronchoalveolar lavage (BAL) fluid. Therapy with co-trimoxazole and micafungin had no effect. Repeated examination of the BAL fluid did not reveal the DNA of Pneumocystis jirovecii. An extended virological examination revealed OPV RNA in a nasal smear, and ribavirin was added to the therapy. During the following days, normalization of body temperature was noted for the first time, after 3 days there was a regression of ARF. Thus, ribavirin has been shown to be highly effective in cases of confirmed OPV infection.