Influenza A H1N1 pneumonia in a patient with hairy-cell leukemia.
Severe pandemic influenza A virus (H1N1) infection is associated with risk factors such as pregnancy, obesity and immunosuppression. Immunocompromised patients are at increased risk of more severe or prolonged infection. We report a case of a hairy cell leukemia patient with H1N1 pneumonia which caused severe and prolonged illness. H1N1 virus pneumonia with meticillin-resistant Staphilococcus Aerues (MRSA) coinfection causing Acute Lung Injury (ALI) was treated with a double-dose of osentamyvir, a high dose of teicoplanin and a low dose of corticosteroids. Haematological findings included leucopenia, neutropenia, lymphopenia, reduction of gamma-globulins and natural killer (NK) cells. Reduction of NK and gamma-globulins may explain the development of severe illness and the prolonged illness Neutropenia may explain the MRSA co-infection. Lymphopenia is directly associated with virus action and is considered to be a marker of the swine influenza in adults.
Nicolini
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Division of Respiratory Diseases, General Hospital, Sestri Levante, Genova, Italy. antonello.nicolini@fastwebnet.it
Perazzo
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D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D007943:Leukemia, Hairy Cell / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000628:therapy / Q000821:virology*