PMID- 21055307
OWN - NLM
STAT- MEDLINE
DCOM- 20110324
LR  - 20160607
IS  - 0578-1310 (Print)
IS  - 0578-1310 (Linking)
VI  - 48
IP  - 8
DP  - 2010 Aug
TI  - [Clinical analysis of children with lymphoma complicated with severe pneumonia 
      due to novel influenza A (H1N1) virus infection].
PG  - 610-3
AB  - OBJECTIVE: To study the clinical features and treatment of severe pneumonia due 
      to novel influenza A (H1N1) virus in children with lymphoma during chemotherapy. 
      METHOD: The clinical manifestations, radiologic features, reasons of 
      misdiagnosis, experiences in treatment and prognosis of 4 children with lymphoma 
      complicated with pneumonia due to novel influenza A (H1N1) virus during 
      chemotherapy were analyzed retrospectively. RESULT: Four children out of the 54 
      patients with hematologic disorders who were receiving chemotherapy suffered from 
      H1N1 influenza. Neutrophil counts were less than 0.5 x 10(9)/L in all 4 patients. 
      The body temperature was higher than 39 degrees C accompanied by chill and low blood 
      pressure at the onset of the illness. Dyspnea and hypoxemia occurred quickly. Two 
      of them developed acute respiratory distress syndrome (ARDS). C-reactive protein 
      (CRP) was higher than 50 mg/L in all these cases, and was higher than 200 mg/L in 
      2 cases. Chest X-ray showed that there were extensive infiltrations in several 
      lung lobes in all the 4 patients. The first patient was misdiagnosed as sepsis at 
      the beginning. The results of 17 blood cultures for the 4 patients were all 
      negative. Fungi were found in 2 of 20 sputum cultures in 2 patients and these 2 
      patients had been considered as having fungal pneumonias. All the 4 patients were 
      treated with oseltamivir phosphate. The oseltamivir treatment started on the 
      5(th) day in patient number 1, whereas on the 1(st) day in the other 3 patients. 
      Intravenous immunoglobulin (IVIG) was used in all 4 patients. Methylprednisolone 
      was used in 3 patients. After treatment, 2 died and 2 were improved. CONCLUSION: 
      The children with lymphoma who undergo chemotherapy are prone to develop severe 
      pneumonia during epidemics of influenza A H1N1. The pneumonia may be aggravated 
      very quickly and have a higher mortality. The patients might be easily 
      misdiagnosed as sepsis at early stage. The pneumonia may be misdiagnosed as 
      fungal infection. During H1N1 prevalent season when high fever occurred, H1N1 
      infection should be considered. Early detection of the virus and use of 
      oseltamivir phosphate and high-dose IVIG and methylprednisolone might reduce the 
      mortality.
FAU - Zhang, Rui
AU  - Zhang R
AD  - Department of Hematology, Beijing Children's Hospital, Capital Medical 
      University, Beijing 100045, China.
FAU - Jin, Ling
AU  - Jin L
FAU - Jin, Mei
AU  - Jin M
FAU - Yang, Jing
AU  - Yang J
FAU - Duan, Yan-long
AU  - Duan YL
FAU - Huang, Shuang
AU  - Huang S
FAU - Cheng, Hua
AU  - Cheng H
FAU - Zeng, Jin-jin
AU  - Zeng JJ
FAU - Zhang, Yong-hong
AU  - Zhang YH
LA  - chi
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhonghua Er Ke Za Zhi
JT  - Zhonghua er ke za zhi = Chinese journal of pediatrics
JID - 0417427
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Influenza A Virus, H1N1 Subtype
MH  - Lymphoma, Non-Hodgkin/*complications/*virology
MH  - Male
MH  - Pneumonia, Viral/*complications/diagnosis/*therapy
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2010/11/09 06:00
MHDA- 2011/03/25 06:00
CRDT- 2010/11/09 06:00
PHST- 2010/11/09 06:00 [entrez]
PHST- 2010/11/09 06:00 [pubmed]
PHST- 2011/03/25 06:00 [medline]
PST - ppublish
SO  - Zhonghua Er Ke Za Zhi. 2010 Aug;48(8):610-3.