Successful Treatment of Respiratory Syncytial Virus Infection in an Immunocompromised Patient With Ribavirin

Respiratory syncytial virus (RSV) is a frequent cause of respiratory tract infections in children. Still, it can also cause seasonal outbreaks affecting persons of all ages, especially those with comorbidities or immunocompromised states. Ribavirin is one of the two approved therapies for the treatment of RSV respiratory tract infections. Unfortunately, its aerosolized formulation has been approved only in children, and the oral formulation is not frequently used to treat the infection. However, ribavirin has demonstrated morbidity and mortality benefit in immunocompromised patients. A 70-year-old female had started chemotherapy for a diagnosis of B-cell acute lymphoblastic leukemia (B-ALL). She developed an upper respiratory tract infection (URTI) along with positive RSV status. We started her on oral ribavirin therapy, which had to be stopped after five days of treatment due to an acute hemolytic reaction. She was re-initiated on oral ribavirin after cessation of medication for seven days and showed improvement. Therefore, ribavirin can be used in immunocompromised patients with RSV infection under proper supervision.