How serious is HMPV in a 5-year-old with CRP 22?

Question

Hello doctor,

My 5-year-old niece has been coughing severely for two weeks. The doctor said it is human metapneumovirus (HMPV), but how does it differ from the flu or respiratory syncytial virus (RSV)? She had a fever for four days last week, and one night, her oxygen level dropped to 92 percent, so we rushed her to the emergency room. They administered a nebulizer, and she felt better, but she still had wheezing, and her chest felt tight. We have a history of asthma in the family; could this develop into asthma later? Her blood test showed a white blood cell (WBC) count of 13,000 and a C-reactive protein (CRP) of 22. Are these levels very high? She also had bronchiolitis when she was two years old. Could this be why she is getting sick more often? We are giving her Montelukast and Levocetirizine (Montair LC), but how long does this virus typically take to fully resolve? I am worried because she has missed so much school, and she looks so weak. Should we get a chest X-ray again to check if her lungs are clear now?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Human metapneumovirus (HMPV) is a respiratory virus similar to the flu or respiratory syncytial virus (RSV), but it can cause more severe breathing issues in children with a history of lung problems. The fever for four days and the oxygen drop to 92 percent were concerning, but it is good she improved after the nebulizer. The wheezing and chest tightness suggest airway inflammation. Given the family history of asthma and her past bronchiolitis, she is at higher risk for reactive airway disease or asthma. A white blood cell (WBC) count of 13,000 and a C-reactive protein (CRP) of 22 indicate inflammation, but these levels are not extremely high. Recovery from the virus can take two to four weeks. Montelukast and Levocetirizine (Montair LC) help with inflammation, but full recovery takes time. If she continues to have breathing issues or weakness, a chest X-ray could help assess for lingering infection or pneumonia. Rest, hydration, and monitoring are essential.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.