Life-threatening diffuse alveolar hemorrhage associated with Rhinovirus infection and the potential role of corticosteroids in immunocompetent patients: Case reports.
- 1Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
- 2Chonnam National University Medical School, Gwangju, Republic of Korea.
Abstract
Rationale
Diffuse alveolar hemorrhage (DAH) is a rare but potentially fatal condition characterized by bleeding into alveolar spaces, most often associated with autoimmune disease or severe infection. Rhinovirus is a common cause of upper respiratory tract infection but is rarely associated with DAH in immunocompetent individuals. We report 2 cases of life-threatening DAH associated with rhinovirus infection, both presenting with severe hypoxemia and showing marked improvement following corticosteroid therapy.Patient concerns
Case 1: An 85-year-old woman presented with massive hemoptysis, dyspnea, and hypoxemia. Chest computed tomography (CT) revealed diffuse ground-glass opacities (GGOs) and patchy consolidations. Case 2: A 70-year-old woman developed worsening dyspnea and hemoptysis despite antibiotics. She was hypoxemic, and chest CT showed bilateral GGOs and consolidations.Diagnoses
Bronchoalveolar lavage fluid demonstrated progressively hemorrhagic aliquots consistent with DAH in both cases. Multiplex viral polymerase chain reaction identified rhinovirus as the sole pathogen in both cases, and autoimmune serologic tests were negative.Interventions
Both patients received high-flow oxygen therapy, empirical antibiotics, and systemic corticosteroids (Case 1: intravenous methylprednisolone 1 mg/kg/day; Case 2: intravenous methylprednisolone 500 mg/day for 3 days, followed by tapering).Outcomes
After corticosteroid therapy, both patients showed rapid clinical and radiographic improvement, with resolution of hypoxemia and discharge within 10 days.Lessons
These cases suggest a potential association between rhinovirus infection and life-threatening DAH in immunocompetent patients. Both patients showed marked clinical improvement after corticosteroid therapy, suggesting a potential therapeutic role for systemic corticosteroids. Thus, clinicians should consider rhinovirus infection as a possible infectious trigger of DAH, and systemic corticosteroids may be considered in selected severe cases.
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BibTeX
@article{yoon2026lifethreatening,
title = {{Life-threatening diffuse alveolar hemorrhage associated with Rhinovirus infection and the potential role of corticosteroids in immunocompetent patients: Case reports.}},
author = {Chang-Seok Yoon and Joon-Young Yoon and Bo-Gun Kho and Tae-Ok Kim and Yong-Soo Kwon and Yu-Il Kim and Sung-Chul Lim and Hong-Joon Shin},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051157},
url = {https://europepmc.org/article/MED/42888641},
note = {CC BY},
}
RIS
TY - JOUR
TI - Life-threatening diffuse alveolar hemorrhage associated with Rhinovirus infection and the potential role of corticosteroids in immunocompetent patients: Case reports.
AU - Chang-Seok Yoon
AU - Joon-Young Yoon
AU - Bo-Gun Kho
AU - Tae-Ok Kim
AU - Yong-Soo Kwon
AU - Yu-Il Kim
AU - Sung-Chul Lim
AU - Hong-Joon Shin
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051157
UR - https://europepmc.org/article/MED/42888641
AB - Rationale Diffuse alveolar hemorrhage (DAH) is a rare but potentially fatal condition characterized by bleeding into alveolar spaces, most often associated with autoimmune disease or severe infection. Rhinovirus is a common cause of upper respiratory tract infection but is rarely associated with DAH in immunocompetent individuals. We report 2 cases of life-threatening DAH associated with rhinovirus infection, both presenting with severe hypoxemia and showing marked improvement following corticosteroid therapy.Patient concerns Case 1: An 85-year-old woman presented with massive hemoptysis, dyspnea, and hypoxemia. Chest computed tomography (CT) revealed diffuse ground-glass opacities (GGOs) and patchy consolidations. Case 2: A 70-year-old woman developed worsening dyspnea and hemoptysis despite antibiotics. She was hypoxemic, and chest CT showed bilateral GGOs and consolidations.Diagnoses Bronchoalveolar lavage fluid demonstrated progressively hemorrhagic aliquots consistent with DAH in both cases. Multiplex viral polymerase chain reaction identified rhinovirus as the sole pathogen in both cases, and autoimmune serologic tests were negative.Interventions Both patients received high-flow oxygen therapy, empirical antibiotics, and systemic corticosteroids (Case 1: intravenous methylprednisolone 1 mg/kg/day; Case 2: intravenous methylprednisolone 500 mg/day for 3 days, followed by tapering).Outcomes After corticosteroid therapy, both patients showed rapid clinical and radiographic improvement, with resolution of hypoxemia and discharge within 10 days.Lessons These cases suggest a potential association between rhinovirus infection and life-threatening DAH in immunocompetent patients. Both patients showed marked clinical improvement after corticosteroid therapy, suggesting a potential therapeutic role for systemic corticosteroids. Thus, clinicians should consider rhinovirus infection as a possible infectious trigger of DAH, and systemic corticosteroids may be considered in selected severe cases.
SN - 0304-5412
SN - 1536-5964
ER -