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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

April 9th–15th chest radiographs: ground-glass opacity was observed on every graph. No significant improvement after treatment. (A): April 9th. (B): April 10th. (C): April 11st. (D): April 12nd. (E): April 14th. (F): April 15th.
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fig3: April 9th–15th chest radiographs: ground-glass opacity was observed on every graph. No significant improvement after treatment. (A): April 9th. (B): April 10th. (C): April 11st. (D): April 12nd. (E): April 14th. (F): April 15th.

Mentions: As the disease progressed further, the patient became critically ill. CT scan on April 6th (day 3) and April 15th (day 12) showed expanded lesions (Figures 2 and 3). The patient developed severe hypoxemia and was incubated for mechanical ventilation. On April 10th (day 7), throat swab specimens were tested positive for A/H7N9 influenza virus. This result was confirmed by Shanghai Municipal Center of Disease Control and Prevention. The patient continued to receive treatment and was tested daily from his throat swab specimens for H7N9 virus. At the time of writing (April 25th), the patient's specimen remained H7N9 positive and the patient's condition remained critical.


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)

April 9th–15th chest radiographs: ground-glass opacity was observed on every graph. No significant improvement after treatment. (A): April 9th. (B): April 10th. (C): April 11st. (D): April 12nd. (E): April 14th. (F): April 15th.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: April 9th–15th chest radiographs: ground-glass opacity was observed on every graph. No significant improvement after treatment. (A): April 9th. (B): April 10th. (C): April 11st. (D): April 12nd. (E): April 14th. (F): April 15th.
Mentions: As the disease progressed further, the patient became critically ill. CT scan on April 6th (day 3) and April 15th (day 12) showed expanded lesions (Figures 2 and 3). The patient developed severe hypoxemia and was incubated for mechanical ventilation. On April 10th (day 7), throat swab specimens were tested positive for A/H7N9 influenza virus. This result was confirmed by Shanghai Municipal Center of Disease Control and Prevention. The patient continued to receive treatment and was tested daily from his throat swab specimens for H7N9 virus. At the time of writing (April 25th), the patient's specimen remained H7N9 positive and the patient's condition remained critical.

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