Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Bainey, KevinR; Sidhu, RobinderS; Sharma, Abhinav; Paterson, IanD

doi:10.4103/2251-9572.218741

Res Cardiovasc Med

2016

DOI: 10.4103/2251-9572.218741

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Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

KevinR Bainey¹,

RobinderS Sidhu²,

Abhinav Sharma³

et al.

Abstract: Introduction: The cardiac manifestations of influenza A are broad, ranging from self-limited pericarditis to fatal cardiomyopathy. The 2009 H1N1 influenza A (H1N1) strain is a rare cause of pericarditis, and its role in developing a pericardial effusion leading to tamponade has infrequently been reported. Case Presentation: We describe a case of a young female with no prior cardiovascular history who presents with a pericardial effusion and shock secondary to cardiac tamponade from pericarditis due to H1N1 inf… Show more

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Cited by 3 publications

References 9 publications

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The Clinical Impact of Cirrhosis on the Hospital Outcomes of Patients Admitted With Influenza Infection: Propensity Score Matched Analysis of 2011–2017 US Hospital Data

Lee¹,

Fan²,

Hastie³

et al. 2021

Journal of Clinical and Experimental Hepatology

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Background/Objectives: Patients with cirrhosis have liver-related immune dysfunction that potentially predisposes the patients to increased influenza infection risk. Our study evaluates this cross-sectional relationship using a national registry of hospital patients. Methods: This study included the 2011-2017 National Inpatient Sample database. From this, respiratory influenza cases were isolated and stratified using the presence of cirrhosis into a cirrhosis-present study cohort and cirrhosis-absent controls; propensity score matching method was used to match the controls to the study cohort (cirrhosis-present) using a 1:1 matching ratio. The endpoints included mortality, length of stay, hospitalization costs, and influenza-related complications. Results: Following the match, there were 2,040 with cirrhosis and matched 2,040 without cirrhosis admitted with respiratory influenza infection. Compared to the controls, cirrhosis patients had higher in-hospital mortality (7.79 vs 3.43% p < 0.001, OR 2.38 95% CI 1.78-3.17), longer length of stay (7.25 vs 6.52 d p < 0.001), higher hospitalization costs ($70,009 vs $65,035 p < 0.001), and were more likely be discharged to a skilled nursing facility and home healthcare (vs routine home discharges). In terms of influenza-related complications, the cirrhosis cohort had higher rates of sepsis (29.8 vs 22% p < 0.001, OR 1.51 95% CI 1.31-1.74). In the multivariate regression analysis, cirrhosis was associated with higher mortality (p < 0.001, aOR 2.31 95% CI 1.59-3.35) and length of stay (p = 0.018, aOR 1.03 95% CI 1.01-1.06). In subgroup analysis of patients with decompensated (n = 597) versus compensated cirrhosis (n = 1443), those with decompensated cirrhosis had higher rates of in-hospital mortality (12.7 vs 5.75% p < 0.001, OR 2.39 95% CI 1.72-3.32), length of stay (8.85 vs 6.59 d p < 0.001), and hospitalization costs ($92,858 vs $60,556 p < 0.001). In the multivariate analysis, decompensated cirrhosis was associated with increased mortality (p < 0.001, aOR 2.86 95% CI 1. 90-4.32). Conclusion: This study shows the presence of cirrhosis to result in higher hospital mortality and postinfluenza complications in patients with influenza infection.

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The Clinical Impact of Cirrhosis on the Hospital Outcomes of Patients Admitted With Influenza Infection: Propensity Score Matched Analysis of 2011–2017 US Hospital Data

Lee¹,

Fan²,

Hastie³

et al. 2021

Journal of Clinical and Experimental Hepatology

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Syncope and Influenza B: A Case of an Arresting Association

Lucerna

Lee

Espinosa

2018

Case Reports in Emergency Medicine

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Influenza is a contagious viral illness that usually presents with upper respiratory and pulmonary symptoms. While generally self-limited, pulmonary, renal, metabolic, neurologic, and cardiac complications have all been described in the literature. Here we describe a case of a 46-year-old male with multiple episodes of syncope, found to have severe bradycardia, sinus arrest, and positive influenza B, requiring permanent pacemaker placement. The viruses responsible for the flu can be differentiated into four types: A, B, C, and D. The two primary viruses responsible for the seasonal winter epidemic influenza in the United States are Human Influenza A and B viruses. It has been postulated that the influenza virus may be responsible for activating acute inflammatory cytokines, which then alter electrical conduction properties of endothelial cells. Although there have been cases of sinus arrest in association with influenza, some requiring pacemaker placement, our patient's presentation with multiple episodes of syncope with severe bradycardia and sinus arrest requiring permanent pacemaker placement, in association with influenza B, is very unusual and possibly unique. Since emergency physicians are at the forefront in the diagnosis, treatment, and disposition of these patients, awareness of influenza triggered cardiac events is essential and lifesaving, especially in unvaccinated patients.

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Complicated Acute Pericarditis and Peripheral Venous Catheter-Related Bloodstream Infection Caused by Methicillin-Resistant Staphylococcus aureus after Influenza B Virus Infection: A Case Report

Ochi¹,

Tauchi

Miura

et al. 2023

Case Reports in Pediatrics

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Background. In this study, we report the case of a 14-month-old female patient transferred from another hospital to our hospital with a 9-day history of fever and worsening dyspnea. Case Report. The patient tested positive for influenza type B virus 7 days before being transferred to our hospital but was never treated. The physical examination performed at presentation revealed redness and swelling of the skin at the site of the peripheral venous catheter insertion performed at the previous hospital. Her electrocardiogram revealed ST segment elevations in leads II, III, aVF, and V2–V6. An emergent transthoracic echocardiogram revealed pericardial effusion. As ventricular dysfunction due to pericardial effusion was not present, pericardiocentesis was not performed. Furthermore, blood culture revealed methicillin-resistant Staphylococcus aureus (MRSA). Thus, a diagnosis of acute pericarditis complicated with sepsis and peripheral venous catheter-related bloodstream infection (PVC-BSI) due to MRSA was made. Frequent bedside ultrasound examinations were performed to evaluate the outcomes of the treatment. After administering vancomycin, aspirin, and colchicine, the patient’s general condition stabilized. Conclusions. In children, it is crucial to identify the causative organism and provide appropriate targeted therapy to prevent worsening of the condition and mortality due to acute pericarditis. Moreover, it is important to carefully monitor the clinical course for the progression of acute pericarditis to cardiac tamponade and evaluate the treatment outcomes.

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Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Cited by 3 publications

References 9 publications

The Clinical Impact of Cirrhosis on the Hospital Outcomes of Patients Admitted With Influenza Infection: Propensity Score Matched Analysis of 2011–2017 US Hospital Data

The Clinical Impact of Cirrhosis on the Hospital Outcomes of Patients Admitted With Influenza Infection: Propensity Score Matched Analysis of 2011–2017 US Hospital Data

Syncope and Influenza B: A Case of an Arresting Association

Complicated Acute Pericarditis and Peripheral Venous Catheter-Related Bloodstream Infection Caused by Methicillin-Resistant Staphylococcus aureus after Influenza B Virus Infection: A Case Report

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