Apnea with RSV infection in three infants receiving palivizumab

The present report describes three infants receiving palivizumab prophylaxis who presented with apnea associated with respiratory syncytial virus (RSV) infection. All three were found to be RSV positive but had mild bronchiolitis courses. Even though palivizumab has been shown to be an effective prophylaxis in preventing RSV bronchiolitis hospitalizations, its effect on apnea is unknown. The cases presented raise the concern that apnea associated with RSV must still be considered in infants who receive proper prophylaxis with palivizumab. Also, if palivizumab is found to be ineffective in preventing apnea, clinical management of these patients could be altered.