title: Organizing pneumonia in patients with severe respiratory failure due to novel A (H1N1) influenza.
abstract: The authors describe two cases that developed organizing pneumonia (OP) associated with novel influenza A(H1N1) virus. These patients were admitted to intensive care unit (ICU) because of severe respiratory failure. After initial clinical improvement, both patients worsened their condition during their second week of ICU stay, presenting fever, increasing in inflammatory parameters and worsening in oxygen exchange and respiratory mechanics. Chest x-rays and computed tomographies showed an increment on lung infiltrates, given by areas of consolidation and ground glass opacification. Although broad-spectrum antibiotics were administered, patients showed no improvement. All cultures, including bronchoalveolar lavage samples, were negative. In both cases, an open lung biopsy was performed, and histopathological examination of the specimen was compatible with OP. Both patients were successfully treated with high-dose corticoids. The aim of this report is to alert about the possibility of OP associated with novel influenza virus in patients with severe respiratory failure.
authors: Medicine Department, Clinical Hospital Universidad de Chile, Santiago, Chile. racornej@gmail.com
authors: Rodrigo
authors: R
authors: Cornejo
authors: Osvaldo
authors: O
authors: Llanos
authors: Cristina
authors: C
authors: Fernández
authors: Juan
authors: J
authors: Carlos Díaz
authors: Gonzalo
authors: G
authors: Cardemil
authors: Jorge
authors: J
authors: Salguero
authors: Cecilia
authors: C
authors: Luengo
authors: Eduardo
authors: E
authors: Tobar
authors: Carlos
authors: C
authors: Romero
authors: Luis Ricardo
authors: LR
authors: Gálvez
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D018549:Cryptogenic Organizing Pneumonia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000821:virology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis*; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008775:Methylprednisolone