Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series

Abstract

Please cite this paper as: Noriega et al. (2010) Pandemic influenza a (H1N1) 2009 with neurological manifestations, a case series. Influenza and Other Respiratory Viruses 4(3), 117–120. Objectives Describe a series of atypical presentations of pandemic influenza A (H1N1) 2009. Methods Description of case series using hospital records. Results Six patients aged 1 to 65 years with confirmed pandemic influenza A (H1N1) 2009 infection presented with neurological complications within 2 to 5 days after the first signs of influenza‐like illness. All six were admitted with seizures or altered mental status. No abnormalities were found in brain scans or cerebral spinal fluid studies of any of the six. All were discharged without sequelae within days of admission. Conclusions This is only the second report of pandemic influenza presenting with neurological manifestations. Clinicians caring for patients when pandemic influenza is prevalent in their communities should maintain a high level of awareness of the potential atypical presentations with which this disease can appear.

Cohort case series of swine flu cases admitted to hospital

“…8 One patient had peripheral neuritis in contrast to seizures and encephalopathy in previous study. 9 One had leucocytosis and rest had leukopenia, 20% had initial thrombocytopenia, 30% rise in transaminases, 20% had elevated serum bilirubin 40% had Pulmonary infiltrates at admission comparable with previous studies. 10 In contrast 40% patients had high ESR, among them one is pregnant, three had pulmonary infiltrates on chest X-ray.…”

Viral Pneumonia and Acute Respiratory Distress Syndrome

“…76 Other important complications of influenza in critically ill patients include venous thromboembolism, myocarditis, rhabdomyolysis, and neurologic manifestations (confusion, seizures, unconsciousness, encephalopathy, quadriparesis, and encephalitis). 77,78 The neuraminidase inhibitors, oseltamivir and zanamivir, are the mainstay of treatment of patients with influenza. Early administration of antiviral therapy may decrease progression to critical illness in hospitalized patients.…”

Encefalopatía aguda y muerte encefálica en un niño con influenza A (H1N1) 2009 durante la primera ola pandémica

“…Aunque cuatro de estos pacientes son descritos por los autores con secuelas neurológicas menores al alta, en la mayoría de los casos la evolución es benigna [6][7][8] . En adultos existen dos series de casos en la literatura, con presentación clínica similar a las series pediátricas y evolución favorable, estudios imagenológicos normales y ausencia de secuelas neurológicas al egreso del hospital [9][10] . Por el contrario, creemos que el caso aquí presentado, si bien constituye una encefalopatía atribuible a infl uenza A (H1N1) pandémica, comparte características clínicas, de laboratorio y radiológicas con la ENA, en razón de la rapidez de instalación del coma, convulsiones, ausencia de pleocitosisis en el LCR y asociado a los hallazgos de la TAC: edema y compromiso bilateral de los ganglios basales.…”