Fatal avian influenza A (H5N1) in a child presenting with diarrhea followed by coma.
In southern Vietnam, a four-year-old boy presented with severe diarrhea, followed by seizures, coma, and death. The cerebrospinal fluid contained 1 white cell per cubic millimeter, normal glucose levels, and increased levels of protein (0.81 g per liter). The diagnosis of avian influenza A (H5N1) was established by isolation of the virus from cerebrospinal fluid, fecal, throat, and serum specimens. The patient's nine-year-old sister had died from a similar syndrome two weeks earlier. In both siblings, the clinical diagnosis was acute encephalitis. Neither patient had respiratory symptoms at presentation. These cases suggest that the spectrum of influenza H5N1 is wider than previously thought.
de Jong
Menno D
MD
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Bach
Van Cam
VC
Phan
Tu Qui
TQ
Vo
Minh Hien
MH
Tran
Tan Thanh
TT
Nguyen
Bach Hue
BH
Beld
Marcel
M
Le
Thi Phuong
TP
Truong
Huu Khanh
HK
Nguyen
Van Vinh Chau
VV
Tran
Tinh Hien
TH
Do
Quang Ha
QH
Farrar
Jeremy
J
D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000821:virology*; D003967:Diarrhea / Q000821:virology*; D018792:Encephalitis, Viral / Q000209:etiology* / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype; D009980:Influenza A virus / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D012640:Seizures / Q000821:virology