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Poor responses to oseltamivir treatment in a patient with influenza A (H7N9) virus infection.

Liu X, Li T, Zheng Y, Wong KW, Lu S, Lu H - Emerg Microbes Infect (2013)

Bottom Line: On the same day, oseltamivir (75 mg bid) treatment was started.The result was confirmed by Shanghai Municipal Center of Disease Control and Prevention.This case calls for increased awareness of potential resistance of H7N9 to oseltamivir.

View Article: PubMed Central - PubMed

Affiliation: Shanghai Public Health Clinical Center Affiliated to Fudan University , Shanghai 201508, China.

ABSTRACT
In March 2013, the cases of human infection with influenza A of H7N9 subtype were first reported. Preliminary data suggested that the H7N9 isolates are sensitive to neuraminidase inhibitors, such as oseltamivir, which is the recommended choice of treatment. On April 2(nd), a 56-year-old male patient was presented with fever and cough to our hospital. He had previous history of close contact with another H7N9 patient. After caring for his wife (a confirmed H7N9 infection case died on April 3(rd)), this patient showed flu like symptoms on April 2(nd). On the same day, oseltamivir (75 mg bid) treatment was started. Throat swab specimens were screened for H7N9 virus by real-time reverse transcriptase-polymerase chain reaction. The patient was hospitalized on April 4(th). Initial specimens on April 4(th) and April 5(th) were negative for H7N9. But the specimen collected on April 10(th) was tested positive for H7N9. The result was confirmed by Shanghai Municipal Center of Disease Control and Prevention. By April 25(th) when we submitted this report, swab specimens of this patient were still positive for H7N9. This case calls for increased awareness of potential resistance of H7N9 to oseltamivir.

No MeSH data available.


Related in: MedlinePlus

CT scan on April 4th, 2013 showed bilateral lower lung inflammatory exudation.
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fig1: CT scan on April 4th, 2013 showed bilateral lower lung inflammatory exudation.

Mentions: On April 2nd we administered oseltamivir as initial treatment. Initial specimens on April 4th (day 1 in hospital) and April 5th (day 2) were negative for H7N9. But the patient's symptoms worsened. On April 5th, the patient remained conscious but he was in a state of hypoxemia, tachypnea, tachycardia, and his body temperature fluctuated between 37.5 °C–39 °C. Hematological and biochemical laboratory tests showed pH 7.47, PaCO2 4.70 kPa, leukocyte count of 5480 with 68.0% neutrophils, prothrombin time 18.0 sec, activated partial thromboplastin time 49 sec, creatine kinase 290.0 U/L, and normal renal and hepatic function tests. Computed tomography (CT) on April 4th showed bilateral lower lung inflammatory exudation associated with acute lung injury (Figure 1). On April 5th, the patient was treated with oseltamivir, moxifloxacin, piperacillin and tazobactam.


Poor responses to oseltamivir treatment in a patient with influenza A (H7N9) virus infection.

Liu X, Li T, Zheng Y, Wong KW, Lu S, Lu H - Emerg Microbes Infect (2013)

CT scan on April 4th, 2013 showed bilateral lower lung inflammatory exudation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3675405&req=5

fig1: CT scan on April 4th, 2013 showed bilateral lower lung inflammatory exudation.
Mentions: On April 2nd we administered oseltamivir as initial treatment. Initial specimens on April 4th (day 1 in hospital) and April 5th (day 2) were negative for H7N9. But the patient's symptoms worsened. On April 5th, the patient remained conscious but he was in a state of hypoxemia, tachypnea, tachycardia, and his body temperature fluctuated between 37.5 °C–39 °C. Hematological and biochemical laboratory tests showed pH 7.47, PaCO2 4.70 kPa, leukocyte count of 5480 with 68.0% neutrophils, prothrombin time 18.0 sec, activated partial thromboplastin time 49 sec, creatine kinase 290.0 U/L, and normal renal and hepatic function tests. Computed tomography (CT) on April 4th showed bilateral lower lung inflammatory exudation associated with acute lung injury (Figure 1). On April 5th, the patient was treated with oseltamivir, moxifloxacin, piperacillin and tazobactam.

Bottom Line: On the same day, oseltamivir (75 mg bid) treatment was started.The result was confirmed by Shanghai Municipal Center of Disease Control and Prevention.This case calls for increased awareness of potential resistance of H7N9 to oseltamivir.

View Article: PubMed Central - PubMed

Affiliation: Shanghai Public Health Clinical Center Affiliated to Fudan University , Shanghai 201508, China.

ABSTRACT
In March 2013, the cases of human infection with influenza A of H7N9 subtype were first reported. Preliminary data suggested that the H7N9 isolates are sensitive to neuraminidase inhibitors, such as oseltamivir, which is the recommended choice of treatment. On April 2(nd), a 56-year-old male patient was presented with fever and cough to our hospital. He had previous history of close contact with another H7N9 patient. After caring for his wife (a confirmed H7N9 infection case died on April 3(rd)), this patient showed flu like symptoms on April 2(nd). On the same day, oseltamivir (75 mg bid) treatment was started. Throat swab specimens were screened for H7N9 virus by real-time reverse transcriptase-polymerase chain reaction. The patient was hospitalized on April 4(th). Initial specimens on April 4(th) and April 5(th) were negative for H7N9. But the specimen collected on April 10(th) was tested positive for H7N9. The result was confirmed by Shanghai Municipal Center of Disease Control and Prevention. By April 25(th) when we submitted this report, swab specimens of this patient were still positive for H7N9. This case calls for increased awareness of potential resistance of H7N9 to oseltamivir.

No MeSH data available.


Related in: MedlinePlus