tailieunhanh - báo cáo khoa học: "Respiratory failure presenting in H1N1 influenza with Legionnaires disease: two case reports"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Respiratory failure presenting in H1N1 influenza with Legionnaires disease: two case reports | lannuzzi et al. Journal of Medical Case Reports 2011 5 520 http content 5 1 520 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Respiratoryfailure presenting in H1N1 influenza with Legionnaires disease two case reports Michele lannuzzi Edoardo De Robertis Ornella Piazza Fabio Rispoli Giuseppe Servillo and Rosalba Tufano Abstract Introduction Media sensationalism on the H1N1 outbreak may have influenced decisional processes and clinical diagnosis. Case Presentation We report two cases of patients who presented in 2009 with coexisting H1N1 virus and Legionella infections a 69-year-old Caucasian man and a 71-year-old Caucasian woman. In our cases all the signs and symptoms including vomiting progressive respiratory disease leading to respiratory failure refractory hypoxemia leukopenia lymphopenia thrombocytopenia and elevated levels of creatine kinase and hepatic aminotransferases were consistent with critical illness due to 2009 H1N1 virus infection. Other infectious disorders may mimic H1N1 viral infection especially Legionnaires disease. Because the swine flu H1N1 pandemic occurred in Autumn in Italy Legionnaires disease was to be highly suspected since the peak incidence usually occurs in early fall. We do think that our immediate suspicion of Legionella infection based on clinical history and X-ray abnormalities was fundamental for a successful resolution. Conclusion Our two case reports suggest that patients with H1N1 should be screened for Legionella which is not currently common practice. This is particularly important since the signs and symptoms of both infections are similar. Keywords Respiratory failure viral infection Legionella swine flu Introduction Media sensationalism with respect to the swine flu outbreak may have influenced decisional processes and clinical diagnosis. We report two cases of patients who present during 2009 in whom H1N1 and Legionella infection coexisted. Secondary bacterial pneumonia is .