Diagnostic dilemmas in a pregnant woman with influenza A (H1N1) infection.
BACKGROUND
Pregnant women are at increased risk for complications from seasonal influenza. Early data suggest that influenza A (H1N1) may present an even greater risk.


METHODS
We present the case of a pregnant woman with severe pulmonary complications from 2009 H1N1 whose care was further complicated by delay in diagnosis and unusual laboratory abnormalities.


CONCLUSIONS
H1N1 may pose several diagnostic challenges for obstetricians, including increased rates of serious pulmonary complications, decreased sensitivity of rapid tests with delay in initiation of antiviral therapy, and abnormal laboratory findings usually associated with other complications of pregnancy. We document these problems, urge initiation of antiviral therapy based on clinical suspicion, and recognize the potential laboratory abnormalities that may be associated with severe influenza illness.
Greer
Laura G
LG
From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Parkland Health and Hospital System, Dallas, Texas.
Abbassi-Ghanavati
Mina
M
Sheffield
Jeanne S
JS
Casey
Brian M
BM
D000328:Adult; D002821:Chorioamnionitis / Q000175:diagnosis / Q000821:virology*; D005260:Female; D005317:Fetal Growth Retardation / Q000821:virology; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007118:Immunoassay; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000821:virology; D011262:Pregnancy Trimester, Second; D012121:Respiration, Artificial; D014776:Virus Cultivation