[Fulminant, life-threatening influenza A/H1N1 virus infection].
Identifieur interne : 000373 ( Main/Exploration ); précédent : 000372; suivant : 000374[Fulminant, life-threatening influenza A/H1N1 virus infection].
Auteurs : S A Weber [Allemagne] ; A. Ostermann ; C. PohlSource :
- Deutsche medizinische Wochenschrift (1946) [ 1439-4413 ] ; 2009.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Allemagne (épidémiologie), Antibactériens (usage thérapeutique), Antiviraux (usage thérapeutique), Grippe humaine (), Grippe humaine (imagerie diagnostique), Grippe humaine (physiopathologie), Grippe humaine (traitement médicamenteux), Humains, Mâle, Oxygénation extracorporelle sur oxygénateur à membrane, Radiographie thoracique, Résultat thérapeutique, Sous-type H1N1 du virus de la grippe A.
- MESH :
- imagerie diagnostique : Grippe humaine.
- physiopathologie : Grippe humaine.
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antibactériens, Antiviraux.
- épidémiologie : Allemagne.
- Adulte d'âge moyen, Grippe humaine, Humains, Mâle, Oxygénation extracorporelle sur oxygénateur à membrane, Radiographie thoracique, Résultat thérapeutique, Sous-type H1N1 du virus de la grippe A.
English descriptors
- KwdEn :
- Anti-Bacterial Agents (therapeutic use), Antiviral Agents (therapeutic use), Extracorporeal Membrane Oxygenation, Germany (epidemiology), Humans, Influenza A Virus, H1N1 Subtype, Influenza, Human (diagnostic imaging), Influenza, Human (drug therapy), Influenza, Human (physiopathology), Influenza, Human (therapy), Male, Middle Aged, Radiography, Thoracic, Treatment Outcome.
- MESH :
- chemical , therapeutic use : Anti-Bacterial Agents, Antiviral Agents.
- diagnostic imaging : Influenza, Human.
- drug therapy : Influenza, Human.
- epidemiology : Germany.
- physiopathology : Influenza, Human.
- therapy : Influenza, Human.
- Extracorporeal Membrane Oxygenation, Humans, Influenza A Virus, H1N1 Subtype, Male, Middle Aged, Radiography, Thoracic, Treatment Outcome.
Abstract
HISTORY AND CLINICAL FINDINGS
A 52-year-old man presented with unproductive cough, fever and chill in our emergency department. Self-medication with amoxicillin over 3 days failed to improve his condition. The patient was in poor general condition. His body temperature was 38.4 C, with a heart rate of 124/min, a blood pressure of 120/70 mmHg and a positive shock index. At auscultation of the chest fine rales were heard over both lungs with diminished percussion sounds basal. The respiratory rate was 30/min and the oxygen saturation of 84% at room air.
INVESTIGATIONS
Laboratory: signs of inflammation; blood gas analysis: pronounced hypoxemia. A chest radiogram revealed signs of extensive pulmonary infiltrates on both sides.
TREATMENT AND COURSE
The patient was admitted to our Intensive Care Unit. He received piperacillin, sulbactam and levoflaxacin, ample fluid and non-invasive ventilation as well as intermittent catecholamine treatment. As there was no clinical improvement the patient was intubated on day 3. On bronchoscopy viral etiology was suspected. At this time the respiratory situation deteriorated. Acute respiratory distress syndrome (ARDS) was diagnosed. An antifungal and antiviral treatment (voriconazol, oseltamivir) was started and a cortisone pulse was attempted. The patient was transferred to another clinic where extracorporeal membranoxygenation (ECMO) was performed on the same day. The following day influenza A/H1N1-test was confirmed. Ten days after transfer, the patient regained spontaneous respiration, and he most likely survives the infection.
CONCLUSION
The incidence of influenza (A/H1N1) has increased in Germany and severe and lethal courses have occurred. Therefore, the diagnostic and treatment algorithms need to be reconsidered in order to rapidly diagnose and treat infections.
DOI: 10.1055/s-0029-1243026
PubMed: 19924608
Affiliations:
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Pohl</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009</date><idno type="RBID">pubmed:19924608</idno><idno type="pmid">19924608</idno><idno type="doi">10.1055/s-0029-1243026</idno><idno type="wicri:Area/Main/Corpus">000372</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000372</idno><idno type="wicri:Area/Main/Curation">000372</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000372</idno><idno type="wicri:Area/Main/Exploration">000372</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Fulminant, life-threatening influenza A/H1N1 virus infection].</title><author><name sortKey="Weber, S A" sort="Weber, S A" uniqKey="Weber S" first="S A" last="Weber">S A Weber</name><affiliation wicri:level="4"><nlm:affiliation>Medizinische Klinik, St. Elisabeth Krankenhaus, Akademisches Lehrkrankenhaus der Universität zu Köln. Sebastian.Weber@hohenlind.de</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Cologne</settlement><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region></placeName><orgName type="university">Université de Cologne</orgName></affiliation></author><author><name sortKey="Ostermann, A" sort="Ostermann, A" uniqKey="Ostermann A" first="A" last="Ostermann">A. Ostermann</name></author><author><name sortKey="Pohl, C" sort="Pohl, C" uniqKey="Pohl C" first="C" last="Pohl">C. Pohl</name></author></analytic><series><title level="j">Deutsche medizinische Wochenschrift (1946)</title><idno type="eISSN">1439-4413</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-Bacterial Agents (therapeutic use)</term><term>Antiviral Agents (therapeutic use)</term><term>Extracorporeal Membrane Oxygenation</term><term>Germany (epidemiology)</term><term>Humans</term><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza, Human (diagnostic imaging)</term><term>Influenza, Human (drug therapy)</term><term>Influenza, Human (physiopathology)</term><term>Influenza, Human (therapy)</term><term>Male</term><term>Middle Aged</term><term>Radiography, Thoracic</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Allemagne (épidémiologie)</term><term>Antibactériens (usage thérapeutique)</term><term>Antiviraux (usage thérapeutique)</term><term>Grippe humaine ()</term><term>Grippe humaine (imagerie diagnostique)</term><term>Grippe humaine (physiopathologie)</term><term>Grippe humaine (traitement médicamenteux)</term><term>Humains</term><term>Mâle</term><term>Oxygénation extracorporelle sur oxygénateur à membrane</term><term>Radiographie thoracique</term><term>Résultat thérapeutique</term><term>Sous-type H1N1 du virus de la grippe A</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Bacterial Agents</term><term>Antiviral Agents</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Germany</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antibactériens</term><term>Antiviraux</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Extracorporeal Membrane Oxygenation</term><term>Humans</term><term>Influenza A Virus, H1N1 Subtype</term><term>Male</term><term>Middle Aged</term><term>Radiography, Thoracic</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Grippe humaine</term><term>Humains</term><term>Mâle</term><term>Oxygénation extracorporelle sur oxygénateur à membrane</term><term>Radiographie thoracique</term><term>Résultat thérapeutique</term><term>Sous-type H1N1 du virus de la grippe A</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>HISTORY AND CLINICAL FINDINGS</b></p><p>A 52-year-old man presented with unproductive cough, fever and chill in our emergency department. Self-medication with amoxicillin over 3 days failed to improve his condition. The patient was in poor general condition. His body temperature was 38.4 C, with a heart rate of 124/min, a blood pressure of 120/70 mmHg and a positive shock index. At auscultation of the chest fine rales were heard over both lungs with diminished percussion sounds basal. The respiratory rate was 30/min and the oxygen saturation of 84% at room air.</p></div><div type="abstract" xml:lang="en"><p><b>INVESTIGATIONS</b></p><p>Laboratory: signs of inflammation; blood gas analysis: pronounced hypoxemia. A chest radiogram revealed signs of extensive pulmonary infiltrates on both sides.</p></div><div type="abstract" xml:lang="en"><p><b>TREATMENT AND COURSE</b></p><p>The patient was admitted to our Intensive Care Unit. He received piperacillin, sulbactam and levoflaxacin, ample fluid and non-invasive ventilation as well as intermittent catecholamine treatment. As there was no clinical improvement the patient was intubated on day 3. On bronchoscopy viral etiology was suspected. At this time the respiratory situation deteriorated. Acute respiratory distress syndrome (ARDS) was diagnosed. An antifungal and antiviral treatment (voriconazol, oseltamivir) was started and a cortisone pulse was attempted. The patient was transferred to another clinic where extracorporeal membranoxygenation (ECMO) was performed on the same day. The following day influenza A/H1N1-test was confirmed. Ten days after transfer, the patient regained spontaneous respiration, and he most likely survives the infection.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The incidence of influenza (A/H1N1) has increased in Germany and severe and lethal courses have occurred. Therefore, the diagnostic and treatment algorithms need to be reconsidered in order to rapidly diagnose and treat infections.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">19924608</PMID><DateCompleted><Year>2009</Year><Month>12</Month><Day>01</Day></DateCompleted><DateRevised><Year>2016</Year><Month>11</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1439-4413</ISSN><JournalIssue CitedMedium="Internet"><Volume>134</Volume><Issue>48</Issue><PubDate><Year>2009</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Deutsche medizinische Wochenschrift (1946)</Title><ISOAbbreviation>Dtsch. Med. Wochenschr.</ISOAbbreviation></Journal><ArticleTitle>[Fulminant, life-threatening influenza A/H1N1 virus infection].</ArticleTitle><Pagination><MedlinePgn>2447-50</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1055/s-0029-1243026</ELocationID><Abstract><AbstractText Label="HISTORY AND CLINICAL FINDINGS" NlmCategory="METHODS">A 52-year-old man presented with unproductive cough, fever and chill in our emergency department. Self-medication with amoxicillin over 3 days failed to improve his condition. The patient was in poor general condition. His body temperature was 38.4 C, with a heart rate of 124/min, a blood pressure of 120/70 mmHg and a positive shock index. At auscultation of the chest fine rales were heard over both lungs with diminished percussion sounds basal. The respiratory rate was 30/min and the oxygen saturation of 84% at room air.</AbstractText><AbstractText Label="INVESTIGATIONS" NlmCategory="METHODS">Laboratory: signs of inflammation; blood gas analysis: pronounced hypoxemia. A chest radiogram revealed signs of extensive pulmonary infiltrates on both sides.</AbstractText><AbstractText Label="TREATMENT AND COURSE" NlmCategory="METHODS">The patient was admitted to our Intensive Care Unit. He received piperacillin, sulbactam and levoflaxacin, ample fluid and non-invasive ventilation as well as intermittent catecholamine treatment. As there was no clinical improvement the patient was intubated on day 3. On bronchoscopy viral etiology was suspected. At this time the respiratory situation deteriorated. Acute respiratory distress syndrome (ARDS) was diagnosed. An antifungal and antiviral treatment (voriconazol, oseltamivir) was started and a cortisone pulse was attempted. The patient was transferred to another clinic where extracorporeal membranoxygenation (ECMO) was performed on the same day. The following day influenza A/H1N1-test was confirmed. Ten days after transfer, the patient regained spontaneous respiration, and he most likely survives the infection.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The incidence of influenza (A/H1N1) has increased in Germany and severe and lethal courses have occurred. Therefore, the diagnostic and treatment algorithms need to be reconsidered in order to rapidly diagnose and treat infections.</AbstractText><CopyrightInformation>Georg Thieme Verlag KG Stuttgart, New York.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Weber</LastName><ForeName>S A</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>Medizinische Klinik, St. Elisabeth Krankenhaus, Akademisches Lehrkrankenhaus der Universität zu Köln. Sebastian.Weber@hohenlind.de</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ostermann</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Pohl</LastName><ForeName>C</ForeName><Initials>C</Initials></Author></AuthorList><Language>ger</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Fulminante, lebensbedrohliche Influenza-A/H1N1-Virusinfektion.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2009</Year><Month>11</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Dtsch Med Wochenschr</MedlineTA><NlmUniqueID>0006723</NlmUniqueID><ISSNLinking>0012-0472</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015199" MajorTopicYN="N">Extracorporeal Membrane Oxygenation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="Y">Influenza A Virus, H1N1 Subtype</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013902" MajorTopicYN="N">Radiography, Thoracic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2009</Year><Month>11</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2009</Year><Month>11</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2009</Year><Month>12</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">19924608</ArticleId><ArticleId IdType="doi">10.1055/s-0029-1243026</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li></country><region><li>District de Cologne</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Cologne</li></settlement><orgName><li>Université de Cologne</li></orgName></list><tree><noCountry><name sortKey="Ostermann, A" sort="Ostermann, A" uniqKey="Ostermann A" first="A" last="Ostermann">A. Ostermann</name><name sortKey="Pohl, C" sort="Pohl, C" uniqKey="Pohl C" first="C" last="Pohl">C. Pohl</name></noCountry><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Weber, S A" sort="Weber, S A" uniqKey="Weber S" first="S A" last="Weber">S A Weber</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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