High-dose glucocorticoid treatment of near-fatal bocavirus lung infection results in rapid recovery

Radiomorphological and pathological–anatomical findings of a patient with near-fatal human bocavirus (HBoV) infection. a) Computed tomography (CT) image after a 7-day course of antibiotic therapy shows bilateral pulmonary infiltrates with interstitial pattern and ground-glass opacities (3 March 2020). b) HBoV-specific fluorescence in situ hybridisation in lung biopsy. Head and tail HBoV genome regions were detected with specific fluorescence probes and tissue was counterstained with DAPI. Yellow and orange dots (arrows) indicate codetection of the head and tail regions of HBoV-DNA. c) Lung biopsy showing fibroblast proliferation (arrows) (haematoxylin and eosin staining). d) Strong infiltration with T-lymphocytes (CD3 staining in brown) in the lung tissue reflecting excessive immune response. e) Chest radiography (anteroposterior view) at initiation of glucocorticoid treatment (day 1) showing multifocal opacities in both lungs with foci of consolidation in the upper-left lobe (5 March 2020), and f) at day 4, demonstrating resolution of the multifocal opacities with demarked consolidation in the upper left lobe (8 March 2020). g) CT image 2 months after treatment demonstrates complete resolution of infiltrates with remaining pre-existing small bullae (26 May 2020).