Influenza A/H1/N1/09 infection in patients with cirrhosis has a poor outcome: a case series.
Seasonal influenza is often unsuspected in cirrhotic patients admitted with pneumonia and acute hepatic decompensation. We report five consecutive patients with influenza A subtype H1N1 2009 strain (influenza A/H1N1/09) admitted to our intensive care unit. All had a short history of rapidly worsening respiratory symptoms, but there were no characteristic clinical or radiographic features. Secondary pulmonary infection was universal. All five patients died, despite prompt institution of oseltamivir and intensive supportive care. A high index of suspicion is needed for influenza infection among patients with decompensated cirrhosis.
Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110 070, India.
Chinmaya Kumar
CK
Bal
Vikram
V
Bhatia
Sachin
S
Kumar
Deepak
D
Saini
Vikas
V
Khillan
Ekta
E
Gupta
Neha
N
Rathor
Ashok
A
Choudhury
Naveen
N
Kumar
Ripu
R
Daman
Shiv Kumar
SK
Sarin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D055815:Young Adult
D000998:Antiviral Agents; D007252:Influenza Vaccines; D053139:Oseltamivir