Produção Nacional
Revisado por pares
Co-infection between the pandemic influenza virus A H1N1 and seasonal influenza A virus in a patient presenting severe acute respiratory disease
2010; Elsevier BV; Volume: 14; Linguagem: Inglês
10.1016/j.ijid.2010.02.1715
ISSN1878-3511
AutoresAline Fiori dos Santos Feltrin, Kristopherson Lustosa Augusto, V. Isper, J. Delamain, B. Kemp, André Ricardo Ribas Freitas, M. Pacola, Rodrigo Nogueira Angerami,
Tópico(s)Influenza Virus Research Studies
ResumoBackground: With the pandemic circulation of the new influenza A/H1N1 virus in 2009, became mandatory to implement the national preparedness plan to improve both health care and laboratory settings activities. However, it is also important a continuous surveillance is essential to promote a better comprehension of mechanisms of transmission, viral virulence, and treatment efficacy. The aim of this study is to describe the clinical, laboratorial, and epidemiological aspects of a fatal case of severe acute respiratory disease (SARD) with simultaneous identification of both pandemic and seasonal influenza A virus. Methods: Retrospective and descriptive study based on information collected in medical records and notification file about a patient hospitalized in Campinas, State of São Paulo, during the first influenza A/H1N1 epidemic period in Brazil. Results: A white female patient, 25 years old, with antecedent of obesity and diabetes, was admitted in July/2009 with 2 days history of fever, cough, sore throat, myalgia, and malaise. On admission, chest X-ray showed bilateral, diffuse, and intersticial-alveolar opacities. Despite the started treatment with oseltamivir, ceftriaxone, and azithromycin, she presented with tachypnoea, tachycardia, cyanosis, and hypoxemia in the day-3 of disease. In day-4, her respiratory pattern progressed to severe respiratory distress, lung hemorrhage, and shock; invasive ventilatory support and vasoactive drugs were introduced. Her outcome was death in the 8-day of disease. The specific RT-PCR performed by Instituto Adolfo Lutz – a public health laboratory reference for laboratorial diagnostic of pandemic influenza virus in Brazil – identified seasonal influenza virus in respiratory secretion and pandemic A/H1N1 pandemic virus in lung specimen collected post morten. Conclusion: In the present case, it is not possible to postulate the real impact of simultaneous infection predicting the poor clinical evolution. However, it reinforces the importance of a continuous and sensitive epidemiological and laboratorial surveillance of respiratory syndromes, during epidemic and interepidemic period, as a strategy to detect early changes in the epidemiological pattern and to know what respiratory virus are circulating, including possible emerging new influenza virus strains eventually more virulent or antiviral resistant. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive
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