Analysis of clinical treatment of the first case of human infection with H7N4 avian influenza virus / 中华传染病杂志

ABSTRACT

Objective To report the clinical management of the first case of human infection with influenza A (H7N4) in the world ,and to explore the clinical characteristics and therapeutic regimen of H7N4 infection in humans .Methods A case of confirmed human infection with influenza A (H7N4) virus was hospitalized in the Third People′s Hospital of Changzhou in Jiangsu Province on January 1st ,2018 . The clinical characteristics and treatment were analyzed by reviewing the clinical data and management of the patient ,and compared with the clinical characteristics of human infection with H 7N9 cases .Results The patient was an elderly woman with hypertension ,who had an exposure history of live poultry before onset .The patient had flu-like symptoms including fever , cough and expectoration . The symptoms worsened in the fifth day and presented as respiratory failure and circulatory disturbance .The count of white blood cells ,lymphocytes and platelets counts declined ,while the levels of aspartate aminotransferase and c-reactive protein slightly increased .The levels of creatine kinase and lactate dehydrogenase deformity increased .The pulmonary lesions manifested as exudation and consolidation of both side in a short period of time after the onset . Treatment was initiated according to the epidemiology history , clinical manifestations ,laboratory and imaging characteristics . The primary diagnosis was human infection of avian influenza virus .The patient was treated with oxygen therapy ,antivirus ,anti-infection and short-duration corticosteroids treatment . Early and timely throat swab specimens were tested . The patient recovered and discharged from hospital after active treatment .It was confirmed by the Chinese Center for Disease Control and prevention that the patient was infected with avian influenza A (H7N4) virus ,and no close contact was infected .Conclusions There are many similarities of clinical features between case of human infection with H7N4 and that of H7N9 . The early treatment of neuraminidase inhibitors is recommended according to the diagnosis and treatment of human infection with H 7N9 .In the clinical practice ,the avian influenza nucleic acid should be tested in time to determine the cause of the disease in those patients with suspected viral pneumonia ,especially in those who has an avian contact history .