Abstract
We report two cases of severe bronchopneumonia due to influenza A (H3N2) virus. The severity of the disease necessitated initiation of empiric therapy based on the present illness and clinical data on admission. Both patients were improved by artificial ventilation with positive end-expiratory pressures and administration of broad spectrum antibiotics and corticosteroids before confirming the diagnosis of viral bronchopneumonia using viral culture and serological tests. Within 24 hours, influenza A (H3N2) virus was identified by amplification of the pathogen genes by reverse transcription polymerase chain reaction (RT-PCR) using the stored bronchoalveolar lavage (BAL) fluids of both cases. This suggests that a combination of detection methods of pathogens using RT-PCR and BAL fluid will facilitate determination of rational treatment aimed at influenza A virus.
MeSH terms
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Aged
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Antibiotic Prophylaxis
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Betamethasone / therapeutic use
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Bronchoalveolar Lavage Fluid / virology
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Bronchopneumonia / etiology*
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Bronchopneumonia / therapy
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Bronchopneumonia / virology
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Cephalosporins / therapeutic use
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Clindamycin / therapeutic use
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Combined Modality Therapy
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Drug Therapy, Combination / therapeutic use
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Fosfomycin / therapeutic use
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Humans
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Influenza A Virus, H3N2 Subtype*
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Influenza A virus / genetics
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Influenza A virus / isolation & purification*
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Male
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Methylprednisolone / therapeutic use
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Middle Aged
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Minocycline / therapeutic use
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Pneumonia, Viral / etiology*
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Pneumonia, Viral / therapy
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Pneumonia, Viral / virology
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Positive-Pressure Respiration
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RNA, Viral / analysis*
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Respiration, Artificial
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Reverse Transcriptase Polymerase Chain Reaction*
Substances
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Cephalosporins
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RNA, Viral
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Fosfomycin
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Clindamycin
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Betamethasone
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Minocycline
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flomoxef
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Methylprednisolone