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1.
Arch. argent. pediatr ; 119(2): e142-e148, abril 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1152045

ABSTRACT

La gripe se asocia al aparato respiratorio, especialmente en invierno, y puede causar complicaciones neurológicas. Se evaluó a pacientes pediátricos con manifestaciones neurológicas graves por gripe desde septiembre de 2018 hasta febrero de 2019 para determinar características clínicas, neuroimagenología, tratamiento y resultados. El objetivo fue evaluar la encefalitis asociada a la gripe y destacar diferentes manifestaciones neurológicas y cambios de neuroimagenología. El estudio incluyó a 13 pacientes. Los síntomas neurológicos ocurrieron tras los síntomas típicos de la gripe. Los cambios de neuroimagenología incluyen alteraciones de señal de la sustancia blanca cortical y subcortical, edema localizado o generalizado y lesiones multifocales simétricas bilaterales en el tálamo y la médula del cerebelo. Las opciones terapéuticas incluyen metilprednisolona en inyección intravenosa, inmunoglobulina intravenosa, plasmaféresis y oseltamivir. Es fundamental considerar la encefalitis asociada a la gripe en pacientes con convulsiones, la encefalopatía con hallazgos radiológicos compatibles, e iniciar el tratamiento lo antes posible


Influenza is mostly associated with the respiratory tract system, especially in the winter season. Various neurological complications could occur due to influenza infection. Pediatric patients who had severe neurological manifestations due to influenza infection from September 2018 to February 2019 were evaluated for clinical characteristics, neuroimaging studies, treatment, and outcome. We aimed to assess Influenza-associated encephalitis in children, emphasize different neurological manifestations and neuroimaging changes. Thirteen patients were included in the study. Neurological symptoms occurred after flu-like symptoms. Neuroimaging changes of influenza-associated encephalitis/encephalopathy include cortical and subcortical white matter signal alterations, localized or generalized edema, and bilateral symmetrical multifocal lesions on the thalamus and cerebellar medulla. Pulse methylprednisolone, intravenous immunoglobulin, plasma exchange, and oseltamivir are the therapy choices. It is essential to consider influenza-associated encephalitis in patients with seizures, encephalopathy with supporting radiological findings, especially during the influenza season and starting treatment as fast as possible for better outcomes.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Brain Diseases/diagnostic imaging , Encephalitis/diagnostic imaging , Influenza, Human/complications , Turkey/epidemiology , Brain Diseases/therapy , Encephalitis/therapy , Neuroimaging , Neurologic Manifestations
4.
Chinese Medical Journal ; (24): 2410-2414, 2020.
Article in English | WPRIM | ID: wpr-877819

ABSTRACT

BACKGROUND@#The coronavirus disease 2019 (COVID-19) outbreak occurred during the flu season around the world. This study aimed to analyze the impact of influenza A virus (IAV) exposure on COVID-19.@*METHODS@#Seventy COVID-19 patients admitted to the hospital during January and February 2020 in Wuhan, China were included in this retrospective study. Serum tests including respiratory pathogen immunoglobulin M (IgM) and inflammation biomarkers were performed upon admission. Patients were divided into common, severe, and critical types according to disease severity. Symptoms, inflammation indices, disease severity, and fatality rate were compared between anti-IAV IgM-positive and anti-IAV IgM-negative groups. The effects of the empirical use of oseltamivir were also analyzed in both groups. For comparison between groups, t tests and the Mann-Whitney U test were used according to data distribution. The Chi-squared test was used to compare disease severity and fatality between groups.@*RESULTS@#Thirty-two (45.71%) of the 70 patients had positive anti-IAV IgM. Compared with the IAV-negative group, the positive group showed significantly higher proportions of female patients (59.38% vs. 34.21%, χ = 4.43, P = 0.035) and patients with fatigue (59.38% vs. 34.21%, χ = 4.43, P = 0.035). The levels of soluble interleukin 2 receptor (median 791.00 vs. 1075.50 IU/mL, Z = -2.70, P = 0.007) and tumor necrosis factor α (median 10.75 vs. 11.50 pg/mL, Z = -2.18, P = 0.029) were significantly lower in the IAV-positive group. Furthermore, this group tended to have a higher proportion of critical patients (31.25% vs. 15.79%, P = 0.066) and a higher fatality rate (21.88% vs. 7.89%, P = 0.169). Notably, in the IAV-positive group, patients who received oseltamivir had a significantly lower fatality rate (0 vs. 36.84%, P = 0.025) compared with those not receiving oseltamivir.@*CONCLUSIONS@#The study suggests that during the flu season, close attention should be paid to the probability of IAV exposure in COVID-19 patients. Prospective studies with larger sample sizes are needed to clarify whether IAV increases the fatality rate of COVID-19 and to elucidate any benefits of empirical usage of oseltamivir.


Subject(s)
Adult , Aged , Antibodies, Viral/blood , Betacoronavirus , COVID-19 , Coronavirus Infections/mortality , Female , Humans , Immunoglobulin M/blood , Influenza A virus/immunology , Influenza, Human/complications , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index
5.
Rev. Soc. Bras. Med. Trop ; 53: e20200050, 2020.
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1136912

ABSTRACT

Abstract In the present study, we report the incidence of septic shock syndrome associated with methicillin-resistant Staphylococcus aureus in a child who initially presented influenza-like illness and developed septic shock shortly after 48 h of hospitalization, and eventually died within a few hours of the onset of sepsis. S. aureus isolated from the blood culture was characterized as the community-associated strain carrying the staphylococcal cassette chromosome mec (SCCmec) type IV element. Therefore, it is important to better understand the community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections and their potential association with influenza for early diagnosis and successful treatment of this fatal disease.


Subject(s)
Humans , Infant , Shock, Septic/microbiology , Staphylococcal Infections/microbiology , Influenza, Human/diagnosis , Methicillin-Resistant Staphylococcus aureus , Shock, Septic/complications , Staphylococcal Infections/complications , Staphylococcal Infections/diagnosis , Fatal Outcome , Influenza, Human/complications
6.
Cad. Saúde Pública (Online) ; 36(7): e00149420, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1124312

ABSTRACT

O presente estudo tem o objetivo de descrever os pacientes hospitalizados por síndrome respiratória aguda grave (SRAG) em decorrência da COVID-19 (SRAG-COVID), no Brasil, quanto às suas características demográficas e comorbidades até a 21ª Semana Epidemiológica de 2020. Buscou-se comparar essas características com as dos hospitalizados por SRAG em decorrência da influenza em 2019/2020 (SRAG-FLU) e com a população geral brasileira. As frequências relativas das características demográficas, comorbidades e de gestantes/puérperas entre os pacientes hospitalizados por SRAG-COVID e SRAG-FLU foram obtidas por meio do Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe), e as estimativas para a população geral brasileira foram obtidas por meio de projeções populacionais realizadas pelo Instituto Brasileiro de Geografia e Estatística, dados do Sistema de Informações sobre Nascidos Vivos e de pesquisas de âmbito nacional. Entre os hospitalizados por SRAG-COVID, observou-se uma elevada proporção, em relação ao perfil da população geral brasileira, de indivíduos do sexo masculino, idosos ou com 40 a 59 anos, com comorbidades (diabetes mellitus, doença cardiovascular, doença renal crônica e pneumopatias crônicas) e de gestantes/puérperas. Já entre os hospitalizados por SRAG-FLU, observou-se prevalências superiores às populacionais de indivíduos de 0 a 4 anos de idade ou idosos, de raça ou cor branca, com comorbidades (diabetes mellitus, doença renal crônica, asma e outras pneumopatias crônicas) e de gestantes/puérperas. Esses grupos podem estar evoluindo para casos mais graves da doença, de forma que estudos longitudinais na área são de extrema relevância para investigar esta hipótese e melhor subsidiar políticas públicas de saúde.


El objetivo del presente estudio es describir a los pacientes hospitalizados por infección respiratoria aguda grave (IRAG) a consecuencia de la COVID-19 (IRAG-COVID), en Brasil, respecto a sus características demográficas y comorbilidades hasta la 21ª Semana Epidemiológica de 2020. Se buscó comparar estas características con las de los hospitalizados por SRAS, a consecuencia de la influenza en 2019/2020 (IRAG-FLU) y con la población general brasileña. Las frecuencias relativas de las características demográficas, comorbilidades y de embarazadas/puérperas entre los pacientes hospitalizados por IRAG-COVID y IRAG-FLU se obtuvieron mediante el Sistema de Información de la Vigilancia Epidemiológica de la Gripe (SIVEP-Gripe), y las estimaciones para la población general brasileña se consiguieron mediante proyecciones poblacionales realizadas por el Instituto Brasileño de Geografía e Estadística, datos del Sistema de Informaciones sobre Nascidos Vivos y de investigaciones de ámbito nacional. Entre los hospitalizados por IRAG-COVID, se observó una elevada proporción, respecto al perfil de la población general brasileña, de individuos del sexo masculino, ancianos o con 40 a 59 años, con comorbilidades (diabetes mellitus, enfermedad cardiovascular, enfermedad renal crónica y neumopatías crónicas) y de embarazadas/puérperas. Ya entre los hospitalizados por IRAG-FLU, se observaron prevalencias superiores a las poblacionales de individuos de 0 a 4 años de edad o ancianos, de raza o color blanco, con comorbilidades (diabetes mellitus, enfermedad renal crónica, asma y otras neumopatías crónicas) y de embarazadas/puérperas. Estos grupos pueden estar evolucionando hacia casos más graves de la enfermedad, por ello, los estudios longitudinales en esta área son de extrema relevancia para investigar esta hipótesis y apoyar mejor las políticas públicas de salud.


The study aims to describe patients hospitalized for severe acute respiratory illness (SARI) due to COVID-19 (SARI-COVID) in Brazil according to demographic characteristics and comorbidities up to the 21st Epidemiological Week of 2020. The study aimed to compare these characteristics with those of patients hospitalized for SARI due to influenza in 2019/2020 (SARI-FLU) and with the Brazilian general population. The proportions of demographic characteristics, comorbidities, and pregnant and postpartum women among patients hospitalized for SARI-COVID and SARI-FLU were obtained from the SIVEP-Gripe database, and the estimates for the Brazilian population were obtained from the population projections performed by Brazilian Institute of Geography and Statistics, Information System on Live Birth data, and nationwide surveys. Compared to the Brazilian population, patients hospitalized for SARI-COVID showed a higher proportion of males, elderly individuals and those aged 40 to 59 years, comorbidities (diabetes mellitus, cardiovascular disease, chronic kidney disease, and chronic lung diseases), and pregnant/postpartum women. Compared to the general population, Brazilians hospitalized for SARI-FLU showed higher prevalence rates of ages 0 to 4 years or over 60 years, white race/color, comorbidities (diabetes, chronic kidney disease, asthma, and other chronic lung diseases), and pregnant/postpartum women. The data suggest that these groups are evolving to more serious forms of the disease, so that longitudinal studies are extremely relevant for investigating this hypothesis and supporting appropriate public health policies.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Severe Acute Respiratory Syndrome/virology , Influenza, Human/epidemiology , Pneumonia, Viral/complications , Brazil/epidemiology , Comorbidity , Demography , Prevalence , Coronavirus Infections/complications , Severe Acute Respiratory Syndrome/epidemiology , Influenza, Human/complications , Pandemics , Betacoronavirus , SARS-CoV-2 , COVID-19 , Hospitalization , Middle Aged
8.
Rev. méd. Chile ; 147(7): 922-927, jul. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058622

ABSTRACT

Neurological manifestations associated with influenza virus infection include encephalitis, encephalopathy, acute necrotizing encephalitis, transverse myelitis, acute disseminated encephalomyelitis, mild encephalitis with reversible splenial syndrome (MERS), and Guillaín Barré syndrome. We report a 16-year-old female who was admitted at our emergency department with seizures, confusion, nystagmus and motor clumsiness five days after an upper a respiratory tract infection. Influenza type B virus infection was confirmed by chain polymerase reaction analysis. The initial electroencephalogram demonstrated a pattern of global slowness without epileptic discharges. One week later, it showed a progression to slow-wave focal bilateral discharges at both temporal and occipital lobes. The patient had a favorable evolution and was discharged 19 days after admission with phenytoin to prevent seizures.


Subject(s)
Humans , Female , Adolescent , Influenza B virus/isolation & purification , Encephalitis/virology , Influenza, Human/complications , Electroencephalography , Encephalitis/diagnosis , Influenza, Human/diagnosis , Influenza, Human/virology
9.
Rev. bras. ter. intensiva ; 30(1): 127-130, jan.-mar. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-899566

ABSTRACT

RESUMO No período sazonal compreendido entre 2014 e 2015, a maior parte das infecções por influenza decorreu do vírus influenza A H3N2. Mais de dois terços dos vírus influenza A H3N2 circulante eram antigênica e geneticamente diferentes (drift) do componente A H3N2 da vacina da influenza sazonal 2014 - 2015 para os hemisférios norte e sul. O objetivo deste trabalho foi relatar um caso de infecção por influenza A sazonal não H1N1 ocorrido em junho de 2015 em um paciente adulto com fibrose cística com doença pulmonar grave, previamente vacinado com a vacina antigripal trivalente. O paciente evoluiu com insuficiências respiratória e renal (sem rabdomiólise), sendo submetido à ventilação mecânica e à hemodiálise. A evolução clínica foi positiva após 39 dias de permanência hospitalar. Ainda, o paciente permaneceu clinicamente estável após seguimento de 18 meses. Com os avanços recentes na medicina intensiva e no tratamento, a sobrevivência com uma doença pulmonar avançada na fibrose cística apresenta novas questões e problemas potenciais, que ainda estão sendo formulados.


ABSTRACT In the 2014 - 2015 season, most influenza infections were due to A (H3N2) viruses. More than two-thirds of circulating A (H3N2) viruses are antigenically and genetically different (drifted) from the A (H3N2) vaccine component of 2014 - 2015 northern and southern Hemisphere seasonal influenza vaccines. The purpose of this paper is to report a case of seasonal influenza A non-H1N1 infection that occurred in June 2015 in an adult cystic fibrosis patient with severe lung disease previously vaccinated with the anti-flu trivalent vaccine. The patient evolved to respiratory and renal failure (without rhabdomyolysis) and was placed under mechanical ventilation and hemodialysis. The clinical outcome was positive after 39 days of hospital stay. In addition, the patient was clinically stable after 18 months of follow-up. With the recent advances in critical care medicine and in cystic fibrosis treatment, survival with advanced pulmonary disease in cystic fibrosis presents new questions and potential problems, which are still being formulated.


Subject(s)
Humans , Male , Adult , Respiratory Insufficiency/virology , Cystic Fibrosis/complications , Influenza, Human/complications , Acute Kidney Injury/virology , Orthomyxoviridae/isolation & purification , Respiration, Artificial , Respiratory Insufficiency/therapy , Influenza Vaccines/administration & dosage , Acute Disease , Follow-Up Studies , Renal Dialysis , Influenza, Human/virology , Acute Kidney Injury/therapy
10.
Actual. SIDA. infectol ; 25(96): 70-79, 20170000. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1355243

ABSTRACT

Introducción: La infección por influenza puede conllevar a graves compli-caciones, y poner en riesgo la vida. El objetivo de este trabajo fue des-cribir las características de los casos graves confirmados de influenza en la Provincia de Santa Fe durante el año 2016. Materiales y métodos: Descripción epidemiológica a partir de los datos de las fichas individuales ETI (enfermedades tipo influenza) de los casos de síndrome gripal atendidos en los servicios de salud de la provincia. Resultados: De un total de 211 casos graves confirmados, 63 fallecie-ron. El subtipo viral detectado con mayor frecuencia fue influenza A H1N1 (87,67 %). La mayor letalidad se produjo entre los mayores de 65 años (57,58 %). La chance de morir fue 2,7 veces mayor en los ca-sos en los que la administración del antiviral se demoró más de 48 horas de iniciados los síntomas (IC: 1,01-7,40; P < 0,05). Los facto-res de riesgo con mayor prevalencia fueron: EPOC (28,48 %), edad me-nor de 5 años y pacientes obesidad (23,84 %). La chance de morir fue 2,4 mayor en aquellos que presentaban al menos un factor de riesgo(OR: 2,397; 1,119-5,132; p < 0,05). De 22 vacunados, 4 fallecieron (18,18 %), todos con algún factor de riesgo asociado, mientras que de 148 no-vacunados, 50 fallecieron (33,78 %), 40 con al menos algún factor de riesgo asociado. Conclusión: La información epidemiológica recaba-da es importante para organizar y priorizar los re-cursos de salud de manera eficiente, principalmen-te en aquellos grupos en los que la gravedad de la enfermedad puede llevar a la muerte


ntroduction: Influenza infection can lead to serious complications and put life at risk. The objective of this work was to describe the characteristics of the severe cases of influenza in Santa Fe province during the year 2016. Materials and methods: An epidemiological description of severe cases of influenza was conducted based on data from the individual ETI (influenza-like-Diseases) files of the cases of influenza syndrome treated in the health services of the province. Results: Of a total of 211 confirmed severe cases, 63 died. The most frequently detected viral subtype was influenza AH1N1 (87.67%). The highest lethality occurred among those patients over 65 years old (57.58%). The chance of dying was 2.7 times higher in cases in which the administration of the antiviral was delayed for more than 48 hours after initiation of symptoms (CI: 1.01-7.40, P <0.05). The most prevalent risk factors were COPD (28.48%), age under 5 years and patients with obesity (23.84%). The chance of dying was 2.4 higher in those who had at least one risk factor (OR: 2.377, 1.119-5.132, p <0.05). Of 22 vaccinated patients, 4 died (18.18%), all had some associated risk factor. Of 148 non-vaccinated patients, 50 died (33.78%), 40 with at least one associated risk factor. Conclusion: The epidemiological information collected is important to organize and prioritize health resources efficiently, especially in those groups where the severity of the disease can lead to death


Subject(s)
Humans , Preventive Health Services , Epidemiologic Studies , Risk Factors , Health Organizations , Influenza, Human/complications , Influenza, Human/mortality , Influenza, Human/prevention & control , Vaccine-Preventable Diseases
11.
Rev. bras. ter. intensiva ; 29(3): 271-278, jul.-set. 2017. tab
Article in Portuguese | LILACS | ID: biblio-899526

ABSTRACT

RESUMO Objetivo: Descrever os desfechos de pacientes com síndrome do desconforto respiratório agudo associada à influenza subtipo H1N1 grave tratados com oxigenação por membrana extracorpórea. Métodos: Trata-se de revisão retrospectiva de uma coorte de pacientes oriunda de um único centro, constituída por adultos com síndrome do desconforto respiratório agudo relacionada com influenza subtipo H1N1 e tratados com oxigenação venovenosa por membrana extracorpórea durante a temporada de inverno no hemisfério norte de 2013/2014. Resultados: Dez pacientes receberam oxigenação venovenosa por membrana extracorpórea para tratamento de influenza subtipo H1N1 entre janeiro de 2013 e março de 2014. Sete deles foram transferidos para nosso centro visando à utilização de oxigenação por membrana extracorpórea dentro de um período de 72 horas após o início da ventilação mecânica. A idade mediana foi de 40 anos, sendo 30% dos pacientes do sexo feminino. O valor mediano da proporção entre pressão parcial de oxigênio e fração inspirada de oxigênio foi de 62,5, sendo o escore RESP mediano de 6. Três pacientes receberam inalação de óxido nítrico e quatro utilizaram posição prona como tratamento de resgate antes de ser iniciada a oxigenação por membrana extracorpórea. A duração mediana da ventilação mecânica foi de 22 dias (variação de 14 - 32). O tempo mediano de permanência na unidade de terapia intensiva foi de 27 dias (variação de 14 - 39). O tempo mediano de permanência no hospital foi de 29,1 dias (variação de 16,0 - 46,9). Ocorreram complicações não importantes de sangramento em seis dos dez pacientes. Oito dos dez pacientes sobreviveram até a alta hospitalar. Conclusão: Os sobreviventes eram relativamente jovens e tiveram alta com boas condições funcionais, o que salienta os anos de vida ajustados pela qualidade que foram salvos. Nossa experiência demonstra que mesmo um programa ainda relativamente novo de oxigenação por membrana extracorpórea pode desempenhar um papel importante, e proporcionar resultados excelentes para os pacientes mais graves.


ABSTRACT Objective: This report aimed to describe the outcomes of the patients with severe H1N1 associated acute respiratory distress syndrome who were treated with extracorporeal membrane oxygenation therapy. Methods: This retrospective review analyzed a single-center cohort of adult patients with H1N1-related acute respiratory distress syndrome who were managed with veno-venous extracorporeal membrane oxygenation during the winter of 2013/2014. Results: A total of 10 patients received veno-venous extracorporeal membrane oxygenation for H1N1 influenza between January 2013 and March 2014. Seven patients were transferred to our center for extracorporeal membrane oxygenation consideration (all within 72 hours of initiating mechanical ventilation). The median patient age was forty years, and 30% were female. The median arterial oxygen partial pressure to fraction of inspired oxygen ratio was 62.5, and the median RESP score was 6. Three patients received inhaled nitric oxide, and four patients were proned as rescue therapy before extracorporeal membrane oxygenation was initiated. The median duration of mechanical ventilation was twenty-two days (range, 14 - 32). The median length of stay in the intensive care unit was twenty-seven days (range, 14 - 39). The median hospital length of stay was 29.1 days (range, 16.0 - 46.9). Minor bleeding complications occurred in 6 of 10 patients. Eight of the ten patients survived to hospital discharge. Conclusion: The survivors were relatively young and discharged with good functional status (i.e., enhancing quality-adjusted life-years-saved). Our experience shows that even a relatively new extracorporeal membrane oxygenation program can play an important role in that capacity and provide excellent outcomes for the sickest patients.


Subject(s)
Humans , Male , Female , Adult , Aged , Pneumonia, Viral/complications , Respiratory Distress Syndrome/therapy , Extracorporeal Membrane Oxygenation/methods , Influenza, Human/complications , Pneumonia, Viral/therapy , Respiration, Artificial , Respiratory Distress Syndrome/etiology , Blood Gas Analysis , Retrospective Studies , Treatment Outcome , Quality-Adjusted Life Years , Influenza, Human/therapy , Influenza A Virus, H1N1 Subtype/isolation & purification , Intensive Care Units , Length of Stay , Middle Aged
12.
Rev. méd. Chile ; 145(8): 980-986, ago. 2017. tab
Article in Spanish | LILACS | ID: biblio-902575

ABSTRACT

Background: After the 2009 influenza pandemic the H1N1pdm09 strain circulate seasonally. In 2015, Puerto Montt Hospital in Chile faced a simultaneous outbreak of both seasonal H3N2 and H1N1pdm09 influenza A (IA). Aim: To evaluate the clinical differences between the two viral strains and recent changes in the behavior of H1N1pdm09 IA. Material and Methods: We set up a retrospective study including every adult hospitalized in Puerto Montt Hospital in 2015 due to IA, confirmed by reverse transcription polymerase chain reaction. We compared epidemiological data, clinical presentation, complications, and the outcome of patients with H1N1pdm09 versus those with seasonal influenza. In parallel, we compared 62 cases of thatH1N1 IA from 2015 with 100 cases who were hospitalized and analyzed in 2009. Results: Between July and October 2015, 119 adults with confirmed IA were hospitalized. From 2009 to 2015, the mean age of patients with IAH1N1pdm09 increased from 40.4 ± 17 to 58.8 ± 16 years (p < 0.01). Pneumonia as the cause of hospitalization decreased from 75 to 58% of patients, (p = 0.04). Likewise, the presence of comorbidities increased from 53 to 74%, (p < 0.01). Compared with seasonal H3N2, patients with IAH1N1pdm09 IA were more likely to require intensive care (p < 0.01) and mechanical ventilation (p < 0.01) and developed septic shock (p = 0.03). Their mortality was non-significantly higher (13 and 5% respectively). Conclusions: The clinical presentation of H1N1pdm09 IA has varied over time and now affects an older population, with a greater number of comorbidities. It also appears to be adopting the clinical behavior of a classic seasonal influenza virus.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Influenza, Human/epidemiology , Influenza, Human/virology , Influenza A Virus, H1N1 Subtype/pathogenicity , Pneumonia, Viral/virology , Seasons , Time Factors , Comorbidity , Chile/epidemiology , Disease Outbreaks , Retrospective Studies , Age Factors , Reverse Transcriptase Polymerase Chain Reaction , Influenza, Human/complications , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza A Virus, H3N2 Subtype/isolation & purification , Influenza A Virus, H3N2 Subtype/pathogenicity , Pandemics , Hospitalization/statistics & numerical data
13.
Rev. chil. pediatr ; 88(2): 268-274, abr. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-844610

ABSTRACT

La miositis aguda benigna de la infancia (MABI) es una entidad clínica autolimitada, infrecuente, que afecta a niños en edad preescolar y escolar. Dada su asociación a cuadros virales, se sugiere una relación con este tipo de agentes, entre los que predomina el virus influenza. OBJETIVO: Describir un brote de casos de MABI presentados en un servicio pediátrico. PACIENTES Y MÉTODO: Serie clínica retrospectiva de pacientes que consultaron por un cuadro clínico compatible con MABI en el período agosto-noviembre de 2012, en el Servicio de Urgencia pediátrico de un centro asistencial. RESULTADOS: Se presentan una serie de 9 niños, edades entre 4 y 12 años, con un pródromo de fiebre asociado a síntomas respiratorios, seguido de dolor agudo intenso de ambas pantorrillas y claudicación. En los exámenes de laboratorio destacaba un alza de creatincinasa, con un valor promedio de 4.066 UI/L. El estudio etiológico evidenció influenza B en 3 pacientes y Mycoplasma pneumoniae en uno. El manejo consistió en hidratación y antiinflamatorios no esteroidales, con favorable evolución clínica y de laboratorio. CONCLUSIONES: La MABI es una entidad benigna, autolimitada, de excelente pronóstico, con una presentación clínica que en la mayoría de los casos requiere manejo ambulatorio. Deben evitarse estudios invasivos y hospitalizaciones innecesarias.


Benign acute childhood myositis (BACM) is a rare clinical condition that mainly affects pre-school and school age-children. It is usually preceded by a viral illness, particularly influenza virus infection. OBJECTIVE: To describe a cluster of BACM cases that were seen in a paediatric unit. PATIENTS AND METHODS: A retrospective series of cases that presented with a clinical picture suggestive of BACM between August and November 2012 in the paediatric emergency department of a private clinic. RESULTS: Nine children, between 4 and 12 years, presented with a history of a recent febrile upper viral respiratory infection, followed by intense calf pain and claudication. They all recovered without complications. Laboratory results showed a marked increase in CK, with a mean of 4,066 IU/l. Three of the cases had influenza B infection and one Mycoplasma pneumonia infection. They were managed conservatively with hydration and non-steroidal anti-inflammatory drugs. CONCLUSIONS: BACM is a benign entity with a characteristic clinical presentation that can be managed most of the time in the ambulatory setting, avoiding invasive studies and unnecessary hospital admission.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Respiratory Tract Infections/complications , Influenza, Human/complications , Myositis/etiology , Influenza B virus/isolation & purification , Pneumonia, Mycoplasma/complications , Acute Disease , Retrospective Studies , Myositis/diagnosis , Myositis/therapy
14.
Rev. chil. infectol ; 34(1): 81-86, feb. 2017. ilus, graf
Article in Spanish | LILACS | ID: biblio-844450

ABSTRACT

Acute renal failure (ARF) requiring hemodialysis is not common among patients affected by influenza. We report two unvaccinated adult patients with smoking habit, which were admitted with severe influenza A H1N1pdm09 that evolved with shock and required mechanical ventilation. Both patients developed progressive renal failure with oliguria/anuria, associated with urinary of inflammatory sediment with proteinuria, microhematuria and in one case also with hypocomplementemia, suggesting acute glomerulonephritis. Renal replacement therapy (RRT) was required in both cases. In one patient, who died of late complications, sequencing of the HA1 segment revealed the previously described D222N mutation associated to severe cases. ARF with RRT appears to be an uncommon complication of patients hospitalized for influenza A H1N1pdm09 and may be secondary to acute glomerulonephritis.


La insuficiencia renal aguda (IRA) que requiere hemodiálisis no es una complicación común entre los pacientes afectados por influenza. Se comunican los casos clínicos de dos pacientes adultos fumadores no vacunados, que se internaron por influenza A H1N1pdm09 grave por shock y necesidad de ventilación mecánica. Ambos desarrollaron una falla renal progresiva con oliguria/anuria, asociada a un sedimento de orina inflamatorio con proteinuria, microhematuria y en un caso además con hipocomplementemia, sugiriendo una glomerulonefritis aguda. Se requirió terapia de reemplazo renal (TRR) en ambos casos. En uno de los pacientes, que falleció por complicaciones tardías, la secuenciación del segmento HA1 reveló la mutación D222N previamente descrita en casos graves. La IRA con TRR parece ser una complicación infrecuente de los pacientes ingresados por influenza A H1N1pdm09 y puede ser secundaria a una glomerulonefritis aguda.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Influenza, Human/complications , Influenza A Virus, H1N1 Subtype , Acute Kidney Injury/virology , Glomerulonephritis/virology , Acute Disease , Renal Dialysis , Acute Kidney Injury/therapy , Glomerulonephritis/therapy
15.
Braz. j. infect. dis ; 21(1): 12-18, Jan.-Feb. 2017. tab
Article in English | LILACS | ID: biblio-839178

ABSTRACT

Abstract Background and objective: The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pandemic H1N1 influenza virus strain. Methods: Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention. Comparisons were conducted at the individual-level data of critically ill patients hospitalized with H7N9 (n = 24) or pandemic H1N1 influenza virus (n = 22) infections in Suzhou, China. Changes in cardiac biochemical markers, echocardiography, and electrocardiography during hospitalization in the intensive care unit were considered signs of cardiac complications. Results: The following findings were more common among the H7N9 group relative to the pandemic H1N1 influenza virus group: greater tricuspid regurgitation pressure gradient, sinus tachycardia (heartbeat ≥ 130 bpm), ST segment depression, right ventricular dysfunction, and elevated cardiac biochemical markers. Pericardial effusion was more often found among pandemic H1N1 influenza virus patients than in the H7N9 group. In both groups, most of the cardiac complications were detected from day 6 to 14 after the onset of influenza symptoms. Those who developed cardiac complications were especially vulnerable during the first four days after initiation of mechanical ventilation. Cardiac complications were reversible in the vast majority of discharged H7N9 patients. Conclusions: Critically ill hospitalized H7N9 patients experienced a higher rate of cardiac complications than did patients with 2009 pandemic H1N1 influenza virus infections, with the exception of pericardial effusion. This study may help in the prevention, identification, and treatment of influenza-induced cardiac complications in both pandemic H1N1 influenza virus and H7N9 infections.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Influenza, Human/complications , Influenza A Virus, H1N1 Subtype , Influenza A Virus, H7N9 Subtype , Heart Diseases/virology , Intensive Care Units , Patient Admission , Respiration, Artificial/statistics & numerical data , Time Factors , Severity of Illness Index , Echocardiography , Biomarkers/blood , Retrospective Studies , Risk Factors , Critical Illness , Reverse Transcriptase Polymerase Chain Reaction , Electrocardiography , Influenza, Human/mortality , Heart Diseases/mortality
16.
México, DF; Instituto Mexicano del Seguro Social; 2017.
Monography in Spanish | LILACS | ID: biblio-1097433

ABSTRACT

La guía de referencia rápida tiene como objetivo proporcionar al usuario las recomendaciones clave de la guía. Abordaje diagnóstico y terapéutico de la neumonía viral grave, seleccionadas con base a su impacto en salud por el grupo desarrollador, las cuales pueden variar en función de la intervención de que se trate, así como del contexto regional o local en el ámbito de su aplicación.


Subject(s)
Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Community Health Services/organization & administration , Influenza, Human/complications , Ribavirin/therapeutic use , Radiography, Thoracic/instrumentation , Polymerase Chain Reaction/instrumentation , Oseltamivir/therapeutic use , Zanamivir/therapeutic use , Mexico
17.
J. pediatr. (Rio J.) ; 91(5): 442-447, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-766168

ABSTRACT

ABSTRACT OBJECTIVE: Describe the clinical and laboratory profile, follow-up, and outcome of a series of cases of acute viral myositis. METHOD: A retrospective analysis of suspected cases under observation in the emergency department was performed, including outpatient follow-up with the recording of respiratory infection and musculoskeletal symptoms, measurement of muscle enzymes, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), transaminases (AST and ALT), blood count, C-reactive protein, and erythrocyte sedimentation rate in the acute phase and during follow-up until normalization. RESULTS: Between 2000 and 2009, 42 suspected cases were identified and 35 (27 boys) were included. The median age was 7 years and the diagnosis was reported in 89% in the first emergency visit. The observed respiratory symptoms were cough (31%), rhinorrhea (23%), and fever (63%), with a mean duration of 4.3 days. Musculoskeletal symptoms were localized pain in the calves (80%), limited ambulation (57%), gait abnormality (40%), and muscle weakness in the lower limbs (71%), with a mean duration of 3.6 days. There was significant increase in CPK enzymes (5507 ± 9180 U/L), LDH (827 ± 598 U/L), and AST (199 ± 245 U/L), with a tendency to leukopenia (4590 ± 1420) leukocytes/mm3. The complete recovery of laboratory parameters was observed in 30 days (median), and laboratory and clinical recurrence was documented in one case after 10 months. CONCLUSION: Typical symptoms with increased muscle enzymes after diagnosis of influenza and self-limited course of the disease were the clues to the diagnosis. The increase in muscle enzymes indicate transient myotropic activity related to seasonal influenza, which should be considered, regardless of the viral identification, possibly associated with influenza virus or other respiratory viruses.


RESUMO OBJETIVO: Descrever o perfil clínico-laboratorial, o acompanhamento e o desfecho de uma série de casos de miosite aguda viral. MÉTODO: Foi conduzida uma análise retrospectiva de casos suspeitos, em observação em unidade de emergência, e seguimento ambulatorial com o registro de sintomas de infecção respiratória, sintomas músculo-esqueléticos, determinação de enzimas musculares, creatina-fosfoquinase (CPK), desidrogenase lática (DHL), transaminases (AST e ALT), hemograma, proteína C reativa e velocidade de hemossedimentação, na fase aguda e no acompanhamento, até a normalização. RESULTADOS: Entre 2000 e 2009, 42 casos suspeitos foram identificados e 35 (27 meninos) foram incluídos. A mediana de idade foi de sete anos e o diagnóstico relatado em 89%, na primeira visita de emergência. Os sintomas respiratórios observados foram: tosse (31%), coriza (23%) e febre (63%), com duração média de 4,3 dias. Os sintomas músculo-esqueléticos foram: dor localizada nas panturrilhas (80%), deambulação limitada (57%), marcha anormal (40%) e fraqueza muscular nos membros inferiores (71%), com duração média de 3,6 dias. Observou-se elevação importante das enzimas CPK (5.507 ± 9.180) U/l, DHL (827 ± 598) U/l e AST (199 ± 245) U/l e tendência a leucopenia (4.590 ± 1.420) leucócitos/mm3. A recuperação completa dos parâmetros laboratoriais foi observada em 30 dias (mediana) e a recaída clínica e laboratorial em um caso após 10 meses. CONCLUSÃO: Os sintomas típicos com enzimas musculares elevadas após diagnóstico de influenza e o curso autolimitado foram os indícios para o diagnóstico. A elevação de enzimas musculares indica a atividade miotrópica transitória relacionada à influenza sazonal que deve ser considerada, a despeito da identificação viral, possivelmente associada com o vírus influenza ou outros vírus respiratórios.


Subject(s)
Child , Child, Preschool , Female , Humans , Male , Myositis/virology , Virus Diseases/complications , Acute Disease , C-Reactive Protein/analysis , Clinical Enzyme Tests/methods , Creatine Kinase, MB Form/blood , Creatine Kinase/blood , Influenza, Human/complications , Muscle Weakness/etiology , Myositis/diagnosis , Retrospective Studies , Sex Distribution , Time Factors , Transaminases/blood , Virus Diseases/diagnosis
18.
Rev. méd. Chile ; 143(8): 1070-1075, ago. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-762673

ABSTRACT

Bacterial superinfection is a known complication among patients affected by viral respiratory tract infections. Streptococcus pyogenes, a major bacterial agent involved in acute tonsillopharyngitis, skin and soft tissue infections, was reported as a co-infecting microorganism during the 2009 A H1N1 influenza pandemic. We report a 65-year-old male patient who evolved with multifocal pneumonia and multiple organ failure with a fatal outcome. Influenza A H1N1 was detected by a polymerase chain reaction-based technique from a tracheal aspirate sample. S. pyogenes was identified by a rapid test from a nasopharyngeal sample and isolated afterwards from a positive blood culture.


Subject(s)
Aged , Humans , Male , Influenza A Virus, H1N1 Subtype/genetics , Influenza, Human/complications , Pneumonia/complications , Streptococcus pyogenes/isolation & purification , Coinfection/microbiology , Fatal Outcome , Influenza, Human/diagnosis , Multiple Organ Failure/complications , Polymerase Chain Reaction , Pneumonia , Superinfection/microbiology
19.
Rev. Soc. Bras. Med. Trop ; 48(3): 243-248, May-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-749872

ABSTRACT

INTRODUCTION: The objective of this study was to investigate the possible link between influenza (Flu) infection and Kawasaki disease (KD). METHODS: We examined the medical records of 1,053 KD cases and 4,669 influenza infection cases hospitalized at our institute from January 1, 2011 to December 31, 2013. Cases of KD with concomitant influenza infection formed the KD + Flu group. Each KD + Flu case was matched with 2 KD cases and 2 influenza infection cases, and these cases were assigned to the KD group and Flu group, respectively. The differences in the principal clinical manifestations, course of disease, incomplete KD rate, intravenous immunoglobulin (IVIG) resistance rate, and echocardiographic detection results between the KD + Flu group and KD group were compared. The fever durations and laboratory test results of these three groups were compared. RESULTS: 1) The seasonal variations of the KD + Flu group, KD group and Flu group were similar. 2) The morbidity rate of incomplete KD was higher in the KD + Flu group compared with the KD group. 3) Patients in the KD + Flu group exhibited a longer time to KD diagnosis compared with patients in the KD group. 4) The KD + Flu group exhibited the longest fever duration among the three groups. 5) The CRP and ESR values in the KD + Flu group were higher those in the Flu or KD groups. CONCLUSIONS: Concomitant influenza infection affects the clinical manifestations of KD and can impact the laboratory test results and the diagnosis and treatment of the disease. However, it remains unclear whether influenza contributes to KD etiology. .


Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Influenza, Human/complications , Mucocutaneous Lymph Node Syndrome/complications , Influenza A virus/isolation & purification , Influenza B virus/isolation & purification , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Influenza, Human/virology , Mucocutaneous Lymph Node Syndrome/epidemiology , Retrospective Studies , Seasons
20.
Article in English | IMSEAR | ID: sea-157694

ABSTRACT

Swine influenza is respiratory disease of pigs caused by type A influenza virus that causes regular outbreak in pigs. Human to human transmission occurs. Some people develop severe respiratory symptoms and need ventilator. Patients can get secondary bacterial infections in form of pneumonia if viral infections persist. Death of swine flu occurs due to secondary bacterial infections leading to bacterial pneumonias. Method : 369 patients having acute respiratory illness suspected to be suffering from swine flu were included. Real time reverse transcriptase polymerase chain reaction (RT-PCR) was performed on sputum samples or tracheal aspirates of 134 patients admitted in Hospital due to pneumonia. 90 of these patients were positive for swine flu by RT-PCR. Result : Among 90 patients 55 patients’ shows bacterial growth and 35 patients did not show any growth. Maximum patients 17 shows Klebseilla pneumoniae,17 show Staphylococcus aureus ,10 show Escherichia coli,8 show Pseudomonas aeruginosa and 3 patients show Streptococccus pneumoniae. Even after treatment, death of 36 patients occurred. Among these 36 patients, 19 had both, bacterial as well as swine flu infection and 17 patients had only swine flu infection. Conclusion : Secondary bacterial infections in swine flu patients were multiresistant to antibiotics were noted. Pneumonia caused by co-infection contributes to a severe rapidly progressive illness.


Subject(s)
Coinfection/epidemiology , Coinfection/etiology , Coinfection/microbiology , Coinfection/mortality , Coinfection/therapy , Humans , Influenza A Virus, H1N1 Subtype/drug effects , Influenza, Human/complications , Influenza, Human/epidemiology , Influenza, Human/mortality , Influenza, Human/therapy
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