A Case of Acute Pulmonary Thromboembolism Complicated Pandemic Influenza (H1N1 2009)

Jong Hoo Lee; Miok Kim; Jaechun Lee; Jinseok Kim; Sang Yop Shin

doi:10.3947/ic.2010.42.2.127

Journal List > Infect Chemother > v.42(2) > 1034996

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Lee, Kim, Lee, Kim, and Shin: A Case of Acute Pulmonary Thromboembolism Complicated Pandemic Influenza (H1N1 2009)

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(2): 127-131.

Published online: 30 April 2010

DOI: https://doi.org/10.3947/ic.2010.42.2.127

A Case of Acute Pulmonary Thromboembolism Complicated Pandemic Influenza (H1N1 2009)

Jong Hoo Lee¹, Miok Kim¹, Jaechun Lee¹, Jinseok Kim¹, Sang Yop Shin^1,²

¹Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

²Clinical Research Center for Infectious Disease, Jeju National University, Jeju, Korea.

Corresponding author: Sang Yop Shin, M.D. Department of Internal Medicine, Jeju National University Hospital, 1753-3 Ara 1-dong, Jeju 690-121, Korea. Tel: +82-64-717-1612, Fax: +82-64-717-1131, imdrshin@gmail.com

Received 14 April 2010 Accepted 22 April 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

During the pandemic, few patients have suffered from severe pneumonia leading to acute respiratory distress syndrome (ARDS) and multiple organ dysfunction necessitating prolonged intensive care with higher mortality. Although sepsis and ARDS represent hypercoagulable states, acute pulmonary thromboembolism is rarely encountered in influenza infection. Fifty five year old female patient admitted with pneumonia associated with influenza A infection, progressed into ARDS. Pulmonary thromboembolism was detected by CT scan and treated with anticoagulants. This is the first case report of acute pulmonary thromboembolism in a patient with pandemic influenza (H1N1 2009) in Korea.

Keywords: Pulmonary thromboembolism, Influenza A virus, Respiratory distress syndrome, Peramivir

Figures and Tables

Figure 1

(A) Chest radiograph (admission day 1) shows bilateral pulmonary infiltrates. (B) High resolution CT shows multiple ground-glass attenuations and consolidation on the both lung fields.

Figure 2

(A) Chest CT (admission day 6) shows huge thrombus in the both main pulmonary artery. Thrombus extended to branches of left lower lobar artery. (B) Extensive ground-glass attenuations and consolidations in both lungs. CT findings shows deterioration of lesions comparing to previous chest CT.

Figure 3

(A) Chest CT after anticoagulation therapy (admission day 24) shows small residual thrombus in both main pulmonary artery. (B) Decreased extent of ground-glass attenuations and consolidations in both lungs.

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