title: Two cases of severe bronchopneumonia due to influenza A (H3N2) virus: detection of influenza virus gene using reverse transcription polymerase chain reaction.
abstract: We report two cases of severe bronchopneumonia due to influenza A (H3N2) virus. The severity of the disease necessitated initiation of empiric therapy based on the present illness and clinical data on admission. Both patients were improved by artificial ventilation with positive end-expiratory pressures and administration of broad spectrum antibiotics and corticosteroids before confirming the diagnosis of viral bronchopneumonia using viral culture and serological tests. Within 24 hours, influenza A (H3N2) virus was identified by amplification of the pathogen genes by reverse transcription polymerase chain reaction (RT-PCR) using the stored bronchoalveolar lavage (BAL) fluids of both cases. This suggests that a combination of detection methods of pathogens using RT-PCR and BAL fluid will facilitate determination of rational treatment aimed at influenza A virus.
authors.affiliation: Critical Care Medical Center, Prefectural Hospital of Hiroshima.
authors.forename: M
authors.initials: M
authors.lastname: Doi
authors.forename: S
authors.initials: S
authors.lastname: Takao
authors.forename: K
authors.initials: K
authors.lastname: Kaneko
authors.forename: S
authors.initials: S
authors.lastname: Karakawa
authors.forename: S
authors.initials: S
authors.lastname: Ishihara
authors.forename: Y
authors.initials: Y
authors.lastname: Awaya
authors.forename: M
authors.initials: M
authors.lastname: Kuwabara
authors.forename: S
authors.initials: S
authors.lastname: Ishioka
authors.forename: M
authors.initials: M
authors.lastname: Yamakido
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis; D001623:Betamethasone / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D001996:Bronchopneumonia / Q000209:etiology* / Q000628:therapy / Q000821:virology; D002511:Cephalosporins / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005578:Fosfomycin / Q000627:therapeutic use; D006801:Humans; D053122:Influenza A Virus, H3N2 Subtype; D009980:Influenza A virus / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D011024:Pneumonia, Viral / Q000209:etiology* / Q000628:therapy / Q000821:virology; D011175:Positive-Pressure Respiration; D012367:RNA, Viral / Q000032:analysis*; D012121:Respiration, Artificial; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D002511:Cephalosporins; D012367:RNA, Viral; D005578:Fosfomycin; D002981:Clindamycin; D001623:Betamethasone; D008911:Minocycline; C045693:flomoxef; D008775:Methylprednisolone