Influenza A/H1N1 septic shock in a patient with systemic lupus erythematosus. A case report.
BACKGROUND
Immunocompromised patients, such as systemic lupus erythematosus (SLE) sufferers have an increased risk of mortality, following influenza infection. In the recent pandemic, influenza A H1NI virus caused 18449 deaths, mainly because of adult respiratory distress syndrome or bacterial co-infections.


METHODS
In this case report, an SLE patient with viral-induced septic shock, without overt pulmonary involvement, is discussed. The patient was administered oseltamivir and supportive treatment, including wide-spectrum antibiotics, vasopressors and steroids, according to the guidelines proposed for bacterial sepsis and septic shock. She finally survived and experienced a lupus flare soon after intensive care unit (ICU) discharge.


CONCLUSIONS
To our knowledge, this is the first case to report severe septic shock from influenza A/H1N1 virus, without overt pulmonary involvement.
Clinical Immunology Unit, 2nd Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Konstantinos
K
Tselios
Ritsa
R
Tsioka
Alexandros
A
Sarantopoulos
Eleni
E
Mouloudi
Panagiota
P
Boura
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D053139:Oseltamivir / Q000008:administration & dosage; D013902:Radiography, Thoracic; D012772:Shock, Septic / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D013256:Steroids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D013256:Steroids; D014662:Vasoconstrictor Agents; D053139:Oseltamivir