Luo H, Fan MB, Cao B, Qian SY, Song CP, Zhao AB, Liu KZ, Zhang ZY, Wang CH, Hao GP, Bi HJ
[Clinical experience of successful management of a child with A/H5N1 infection in Shanxi province] [English Abstract, Journal Article]
Zhonghua Jie He He Hu Xi Za Zhi 2009 May; 32(5):351-5.
OBJECTIVE: To explore the clinical features and treatment strategy of human influenza A (H5N1) virus infection.
METHODS: The clinical data from a 2-year-old girl with A/H5N1 infection were collected and analyzed.
RESULTS: The patient had a history of exposure to a living poultry market. A/H5N1 nucleic acid was detected by real-time polymerase chain reaction and reverse-transcription polymerase chain reaction in a nasopharyngeal aspirate. The prominent clinical features included fever, cough and dyspnea. Extensive multiple lobular infiltrates developed quickly, followed by acute respiratory distress syndrome (ARDS) and multi-organ dysfunction. Cortcosteroids, oxygen therapy and non-invasive mechanical ventilation were administrated on day 9 after onset of the disease. The patient's condition became stable after the management. After A/H5N1 infection was confirmed, antiviral treatment with oseltamivir and A/H5N1 vaccinated plasma were used on day 11. Oxgenation and serum enzyme levels returned to normal gradually, and most of the lung infiltrates disappeared. The patient was discharged on day 28.
CONCLUSION: Human A/H5N1 infection is a severe and rapidly progressive disease mostly manifested as ARDS. Corticosteroids may have some effects on the pulmonary lesions, but oxygen therapy and ventilatory support are the mainstay of the management. A/H5N1 vaccinated plasma may be useful for improving the prognosis.
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