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Series of flu-specific cases in a short time breathing children

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  • Pathfinder
    Re: Series of flu-specific cases in a short time breathing children

    (Posted 2009/9/15)

    "Breaking" pandemic in children with rapidly progressive respiratory failure (H1N1) 2009 cases of severe pneumonia

    Introduction: pandemic (H1N1) 2009 epidemic is happening on a global scale, other countries have been reported in severe cases in children 1). And the epidemic is expanding rapidly across the country in our country, and hear reports of severe cases occur in children. 歳 This time, with no history of notable four-year-old influenza A (H1N1) pdm We report a patient who experienced a severe pneumonia virus infection.

    Case: 4-year-old boy.

    born by normal delivery.
    Growth and development history: it is not specifically pointed out the anomaly.
    History: None Notices.
    Family history: Mother: Systemic lupus erythematosus (SLE) dermatomyositis.

    History of present illness: August 23, 2009 (hospital 2 days ago) emerged from wet cough, 24 (day hospitalization) is lively bad, and bad oral intake, 38.5 ℃ night fever has been seen before. SpO Before August 25 doctor visits a day, room air with SpO 2 83% admitted with hypoxemia, chest X confessed to the right lower lung field infiltrate the rays, and visits to the Academy about the same per diem. Consultation at our hospital (after 18 hours after the fever), respiratory rate 60 times / min, SpO 2 92% (Rizabamasuku 6L / min) allowed a disorder marked tachypnea and oxygen, on suspicion of acute bacterial pneumonia hospitalized.

    Physical findings on admission: lucidity, poor general condition. Temperature: 38.8 ℃, blood pressure 94/50 mmHg, heart rate 154 / min, breathing 60 times / min, SpO 2 92% (O 2 mask 6L / min). Chest: found a marked respiratory depression, diminished breath sounds at the bottom of the right lung, right lung field during a hearing rhonchi. crackle hearing did not crackle.

    Laboratory findings on admission: Rapid flu tests A, B negative for both. RS virus, adenovirus-negative rapid test, rapid test negative for IgM anti-mycoplasma. WBC count 14,100 / μl, CRP 3.28 mg / dl and slightly increased inflammatory findings, LDH 270 IU / l, AST 21 IU / l, ALT 8 IU / l and liver enzyme elevation was not deviated. 。 Venous blood gas is, pH 7.419, pCO 2 32.4 mmHg, HCO 3 - 20.6 mmol / l. Photo Chest CT in the lower lobe of the right lung middle lobe and spread infiltrate with air bronchogram, and pleural effusions seen right on the picture was a picture of pneumonia (Figure 1).

    Elapsed after hospitalization: hospitalization with a diagnosis of severe pneumonia, was suspected from the image findings of bacterial pneumonia, inflammatory findings were slightly increased. 慮 Consider the possibility of mycoplasma pneumonia, ampicillin and minocycline treatment is started, the respiratory condition rapidly deteriorated during the evening. Conditions deteriorated even more right to detain the drain for drainage of pleural effusion, the day of admission 18:00 (about 24 hours after fever) began to intubation ventilator management. In addition, rapid influenza tests are positive for influenza type A再検simultaneously, the day turned out to be PCR positive tests AH1pdm virus. After ICU admission, on a ventilator management, oseltamivir, Panipenemu, γ- administration began. Fever continued, but the respiratory condition gradually improved, August 28 (fever of five days of intubation 4 days) in the extubation. し、 From August 29 to defervescence, recurrence after heat rather than worsening respiratory status, September 2 and was discharged the day. 血 As a result, pleural fluid sputum culture-negative blood samples were collected during hospitalization, all were detected only small amount of mucoid Staphylococcus yellow throat.

    Conclusion: Influenza A (H1N1) pdm virus infection, and the easy-to-severe underlying disease and pregnant women, and if you have respiratory disease, severe cases are often reported due to respiratory failure.

    。 A feature of this case, the following three points are listed.

    。 Stir rapidly, after the onset of severe pneumonia in a previously healthy child has no particular underlying disease.
    On the image, the image of bacterial pneumonia was actually slightly increased evidence of inflammation, and culture-negative, one was diagnosed with pneumonia following influenza virus in the end.
    。 Fever, respiratory failure improved more rapidly than day 3, the length of hospital stay was 8 as severe breathing problems and was discharged in the early days.

    Animals from infected tissue, influenza A (H1N1) pdm virus has been reported to be transmitted directly to the lung tissue 2), as in this case, the merger quickly present the findings of pneumonia and bacterial pneumonia images seem at first glance and, like a blood test if infection is suspected, rapid flu test negative even if the A (H1N1) pdm thought to be infected should be addressed in mind.

    The heavy concentration of cases in Japan, which would need to consider the characteristics of patients and severe compared with other countries.,sbd:1

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  • Pathfinder
    Re: Series of flu-specific cases in a short time breathing children

    September 14 7:57 minutes Sankei delivery

    Japan Pediatric Society April 13, decided to close the room up measures to respond rapidly to pandemic influenza. In case a new full-infected children, encephalopathy and prone to be well known to the members to diagnosis and treatment of severe pneumonia, seeking help in dealing with future reports of severe and fatal cases.

    In addition, the new model from a fever and a series of six to 12 cases reported throughout the time of respiratory failure in a short time, to inform the members of these patients. However, because of the nationwide shortage for the pediatric intensive care unit ventilator and required treatment in the field of pediatric防衛医大director of the society we Kei Akira Mountains (Shige Aki) said, "at the moment remain fear and unable to cope with severe pneumonia (utensil) that, "he said, future plans to request such assistance to the country.

    As for Tamiflu and other drugs are administered to all patients regardless of age 1 ~ 5 years of age 1 dose administered with caution to everyone at the discretion of the doctor for years - such as the National Center for Child Health and Development to inform the policy.

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  • Pathfinder
    Re: Series of flu-specific cases in a short time breathing children

    New flu: severe pneumonia in children in Okinawa ... 5 cases Academy of Pediatrics

    September 13, 2009 21:34

    Japan Pediatric Society (President Yokota Shiyunpei) is 13, in children who develop pandemic influenza, said that severe pneumonia is going to be breathing rapidly. 。 If the infected children and their parents that they need a wary eye on the situation.

    According to the society, in Okinawa Prefecture, and the children so far been reported five cases of severe pneumonia who were treated with a ventilator. Symptoms are reflected from the flu and fever symptoms appear 6-12 respiratory condition deteriorated rapidly in the time it will go blank as the inflammation in the lung X-rays.

    Also, the signs of difficulty breathing, fast breathing breathing frequently as part of the chest to collapse when you breathe in blanch the face and lips - that, among others. Accelerate the understanding of the society, along with other severe cases of pneumonia or acute encephalopathy, put together a treatment plan for patients and soon. Eguti Hazime

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  • Sally Furniss
    Re: Series of flu-specific cases in a short time breathing children

    Originally posted by Pathfinder View Post
    If you just heat in a hurry, but if you have a bad breath is to seek medical attention hope "that urges.
    Is this due to ketosis?

    Ketone bodies, from the breakdown of fatty acids to acetyl groups, are also produced during this state, and are burned throughout the body. Excess ketone bodies will slowly decarboxylate into acetone. That molecule is excreted in the breath and urine

    A case of influenza A with hyperglycemia, ketosis, metabolic acidosis, and pancreatitis mimicking rapid-onset type 1 diabetes mellitus.

    Leave a comment:

  • Series of flu-specific cases in a short time breathing children

    Series of flu-specific cases in a short time breathing children
    2009.9.12 21:14

    Topics in the news this: Pandemic Influenza

    Have been on the case quickly to the rapidly deteriorating respiratory status of children infected by pandemic influenza. Even healthy children without a chronic disease, with cases also suffered from breathing difficulties after a few hours out of a high fever, patients are more likely to elementary school. The seasonal flu is not seen as a symptom of the new model has alarmed health authorities. (Imaizumi Yumiko)

    It was fine ...

    "Even if in the morning, I go down the heat ..."

    8 morning in early October. Four-year elementary school boy, Bunkyo-ku, Tokyo clinic were young mothers, "Children's Clinic forest" of the consultation.

    Boy in the evening the day before, visits the clinic with a fever of 39.7 degrees. That children are often run a high fever. し、 President Mori Rankoはprescribed antipyretic, the boy once, but went home, called治Maranai a high fever.

    The boy was relatively healthy in the waiting room for a new infection was suspected, the doctor was waiting in another room about 30 minutes of a sudden change for the worse. A separate room and head into the woods, the boy's face was pale, the state can not talk. Was causing severe breathing difficulties. Next to her mother and brother of the boy read the book, I did not notice the change.

    Surprised by the sudden change in the boy's mother "It was a fine morning ..." his voice choked with. を President Mori has "not seen in 30 seasonal flu cases has changed for the worse up there in a minute," he said.

    The boy was taken to hospital after recovery. President Mori "If they had delayed notice a sudden change in his condition, he was also likely lead to the worst," he recalls.
    Continued to expand new flu earlier this month, President Mori has reported a case of boys in the study session was held in Tokyo pediatrician. Then, out of a pediatrician who attended found that three cases had similar experiences people.

    Focus on elementary school?

    There are similar cases in Fuchu, Tokyo Metropolitan Fuchu Hospital.

    The hospital since late July, was diagnosed with a new child of the 24 children were hospitalized with respiratory condition deteriorated within hours, eight people said. There are many seasonal in severe cases the infant, age of patients was 3-13 years old elementary school more than half.

    Toshiro medical director of the pediatrics department Terakawa said, "the first experience of playing a doctor a long time. I do not know why the focus on elementary school children become severe," he said.

    Although four of the children's hospital who had chronic asthma, the other children did.

    And take one's eyes

    If new infections in children, parents or care what I do.

    According to Professor of Pediatrics Yokota Shiyunpei横浜市立大Japan Pediatric Society and chairman, the child who has a respiratory condition is deteriorating, unable to answer the question abnormally fast breathing ▽ ▽ nose to dread - that symptoms such as .

    "Encephalopathy have been worried about the track and in speaking of the children. However, the new child is also likely to have respiratory condition deteriorated rapidly," said Yokota. "Seasonal, whether new parents have children Kakattara the flu it is important to keep an eye on. If you just heat in a hurry, but if you have a bad breath is to seek medical attention hope "that urges.