title: Hiding in plain sight: H1N1 influenza presenting with respiratory failure and normal chest radiography.
abstract: Sepsis and respiratory failure are uncommon complications of infection with H1N1 influenza. In the majority of cases of H1N1-associated sepsis and respiratory failure found in the literature, evidence of pneumonia or the acute respiratory distress syndrome was seen on chest radiography. This case report describes the clinical characteristics of a patient who presented with septic shock and multi-system organ failure due to H1N1 influenza, but had normal chest radiography. Beyond describing a unique presentation of H1N1-related sepsis, this report highlights the need for clinicians to maintain a high index of suspicion for infection with H1N1 influenza in patients with sepsis and respiratory distress.
authors.affiliation: joefurr@gmail.com
authors.forename: Joe C
authors.initials: JC
authors.lastname: Furr
authors.forename: Victor O
authors.initials: VO
authors.lastname: Kolade
authors.forename: Gary L
authors.initials: GL
authors.lastname: Malakoff
mesh_terms: D001741:Black or African American; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012131:Respiratory Insufficiency / Q000209:etiology*; D012772:Shock, Septic / Q000209:etiology*; D014057:Tomography, X-Ray Computed