Reconocimiento de influenza-A como etiología de síndrome febril e insuficiencia respiratoria en adultos hospitalizados durante brote en la comunidad / Influenza-A as etiology of fever and respiratory insufficiency in adults hospitalized during an outbreak in Chile

RESUMO

Background : Influenza-A (IA) occurs every winter, is mostly observed among outpatients. Aim: To describe the clinical and epidemiological characteristics of cases that required hospital admission during an outbreak in Chile in 1999. Patients and methods: Adults subjects, with Influenza A confirmed by antigen detection test, hospitalized in the clinical hospital of the ½Hospital ClÝnico de la Universidad Católica de Chile¼ between May and June, with fever or respiratory symptoms were studied. A special record was designed to register clinical, microbiological and therapeutic data. Results: Fifty five cases, 26 males, aged 15 to 91 years, were studied. Eighty four percent had chronic concomitant diseases and 9.1 percent were immunosuppressed. Clinical findings were fever in 87.3 percent, asthenia in 83.6 percent, cough in 93.6 percent, abnormal pulmonary signs in 69 percent, an elevated C-reactive protein (mean value of 11.6 ± 7.1 mg/dL) and acute respiratory insufficiency in 54.5 percent. Cases were isolated in cohort or individual rooms and 38.2 percent were admitted to intensive or intermediate care units. Amantadine was prescribed to 52 patients and was well tolerated. Thirty three percent of cases developed pneumonia. These subjects were older, had more dyspnea and respiratory insufficiency than patients without pneumonia. Conclusions: IA should be borne in mind when dealing with hospitalized adults, during epidemic outbreaks in the community. The clinical picture can resemble a serious bacterial infection. An early diagnosis allows the use of specific treatments, to decrease the risk of nosocomial spread and to avoid unnecessary use of antibiotics (Rev MÚd Chile 2004; 132: 317-24).