One case of severe pneumonia and death from H3N8 influenza in human
10.3760/cma.j.cn114452-20230423-00209
- VernacularTitle:人感染H3N8型甲型流感重症肺炎死亡1例
- Author:
Xueqin FENG
1
;
Liangming LI
;
Juan WANG
;
Guishen WU
;
Yang LI
Author Information
1. 中山市人民医院检验医学中心，中山 528403
- Keywords:
Influenza A virus, H3N8 subtype;
Pneumonia;
Multiple myeloma
- From:
Chinese Journal of Laboratory Medicine
2023;46(9):950-954
- CountryChina
- Language:Chinese
-
Abstract:
A female patient, years of age 56, having no distinct inducement before 5 d but developed fever, coughing, and shortness of breath, presented in People′s Hospital of Zhongshan with community-acquired pneumonia on March 3rd, 2023. Influenza A virus infection was confirmed on March 11th after performing macro transcriptome sequencing with alveolar lavage fluid, and H3N8 was confirmed with influenza typing afterward, having declared dead on March 16th. This case is a patient with refractory multiple myeloma autologous stem cell transplantation and continuous chemotherapy with immune dysfunction. She has a history of chronic upper respiratory tract infection. Imaging showed a widespread distribution of plaques, solid lesions, and other pneumonia manifestations in both lungs, a severe decrease in the counts of white blood cells, platelets, neutrophils, and lymphocytes, and a significant increase in laboratory inflammation indicators. After the clinical consideration was an acute aggravation of chronic respiratory tract infection and poor effect of anti-bacterial treatment, fungal infection was considered, and antibiotic treatment was changed several times according to the condition. Still, the outcome was poor, and the disease progressed rapidly. Medical workers initiated Oseltamivir antiviral therapy immediately after the alveolar lavage fluid etiology confirmed A-H3N8 influenza. However, due to complex and varied systemic symptoms, including inflammatory storm, sepsis, acute respiratory failure, tachycardia, coagulopathy, and other extrapulmonary organ injuries, she died 19 days after signs due to severe respiratory failure and multiple organ failure.
