title: Bronchoscopic findings in a child with pandemic novel H1N1 influenza A and methicillin-resistant Staphylococcus aureus.
abstract: The spectrum of disease with pandemic novel H1N1 influenza A (2009) virus ranges from non-febrile, mild upper respiratory tract infection to severe or fatal pneumonia. We report the bronchoscopic findings associated with a fatal case of H1N1 influenza A associated with co-infection with methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy child, which were more severe than those previously described as associated with seasonal influenza infection alone. The severity of the airway pathology seen on bronchoscopy in this patient may be due to a unique effect of the H1N1 influenza A virus or may be as a result of a destructive synergism between this virus and bacteria such as MRSA.
authors.affiliation: Pediatric Pulmonology, State University of New York at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, New York 14222, USA. jksharp@upa.chob.edu
authors.forename: Jack K
authors.initials: JK
authors.lastname: Sharp
authors.forename: James
authors.initials: J
authors.lastname: Hereth
authors.forename: Joseph
authors.initials: J
authors.lastname: Fasanello
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D002648:Child; D017809:Fatal Outcome; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000473:pathology*; D008168:Lung / Q000382:microbiology; D000077731:Meropenem; D055624:Methicillin-Resistant Staphylococcus aureus; D053139:Oseltamivir / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D012131:Respiratory Insufficiency / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D013845:Thienamycins / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D013845:Thienamycins; D053139:Oseltamivir; D014640:Vancomycin; D010959:Tissue Plasminogen Activator; D000077731:Meropenem