title: Severe pneumonia caused by a novel influenza A (H1N1) virus in an asymptomatic emphysematous smoker.
abstract: A 49-year-old female presented with diarrhea and a high fever followed by progressive dyspnea. Until this presentation, she had been healthy except for chronic dyspepsia and diarrhea. She had a smoking habit of 15 pack-years. Laboratory tests revealed lymphopenia, hypoalbuminemia and hypogammaglobulinemia. A rapid influenza test in combination with an RT-PCR assay revealed the presence of the novel influenza A (H1N1) virus. Chest computed tomography revealed centrilobular emphysema. This report suggests that regular smoking may become a risk for severe pneumonia in patients presenting with the novel influenza A (H1N1) virus, when accompanying asymptomatic emphysema is combined with other problems such as hypoalbuminemia and hypogammaglobulinemia.
authors.affiliation: Department of Internal Medicine, Tokai University School of Medicine, Isehara.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ozawa
authors.forename: Satomi
authors.initials: S
authors.lastname: Asai
authors.forename: Guilan
authors.initials: G
authors.lastname: Jin
authors.forename: Yuya
authors.initials: Y
authors.lastname: Hasunuma
authors.forename: Chiharu
authors.initials: C
authors.lastname: Tanaka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Moritsugu
authors.initials: M
authors.lastname: Kimura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ueda
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hayato
authors.initials: H
authors.lastname: Miyachi
mesh_terms: D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000175:diagnosis* / Q000209:etiology; D011656:Pulmonary Emphysema / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*