tetano
Editor, Senior Moderator
Biol Blood Marrow Transplant. 2010 Aug 10. [Epub ahead of print]
Novel H1N1 Influenza In Hematopoietic Stem Cell Transplant Recipients: Two Center's Experience.
Taplitz R, Espinosa-Aguilar L, Green J, Forrest G, Ball E, Maziarz R, Strasfeld L.
Associate Professor of Clinical Medicine, Clinical Director, Division of Infectious Diseases, Department of Medicine, Co-Hospital Epidemiologist, University of California, San Diego, Moore's Cancer Center, 3855 Health Sciences Drive #0960, La Jolla, CA 92093-0960, United States.
Abstract
BACKGROUND: Respiratory virus infections such as influenza A are a cause of significant morbidity in hematopoietic stem cell transplant (HSCT) recipients. The clinical haracteristics and impact of novel H1N1 in this patient population is not yet well defined.
METHODS: HSCT recipients diagnosed with proven or probable H1N1 during the 2009 pandemic were identified and charts retrospectively reviewed with clinical descriptions, risk factors, diagnosis, treatments and outcomes analyzed.
RESULTS: Twenty-seven patients were identified from two medical centers. Fever and cough were the most common presenting symptoms. The incidence of influenza lower respiratory tract infection (LRTI) was 52% (14/27). Compared to patients with LRTI, those with influenza upper respiratory tract infection (URTI) were more likely to have a classic influenza-like syndrome. Those with LRTI were begun on antiviral therapy significantly later after symptom onset (3.0 days vs. 6.58 days after onset of symptoms, p=0.03; 95% CI 0.29, 6.8). Overall influenza-related 30-day mortality was 22% (6/27) and in patients with LRTI was 43 % (6/14). Chronic steroid use (>/= 20 mg/day of prednisone equivalent) at the time of presentation was associated with LRTI (p = 0.006) and mortality (p = 0.003) on univariate analysis. Five cases were hospital acquired.
CONCLUSIONS: In this first season of the novel H1N1 pandemic, infection in HSCT often presented as an atypical and severe illness with a high incidence of LRTI and high mortality.
PMID: 20708084 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20708084
Novel H1N1 Influenza In Hematopoietic Stem Cell Transplant Recipients: Two Center's Experience.
Taplitz R, Espinosa-Aguilar L, Green J, Forrest G, Ball E, Maziarz R, Strasfeld L.
Associate Professor of Clinical Medicine, Clinical Director, Division of Infectious Diseases, Department of Medicine, Co-Hospital Epidemiologist, University of California, San Diego, Moore's Cancer Center, 3855 Health Sciences Drive #0960, La Jolla, CA 92093-0960, United States.
Abstract
BACKGROUND: Respiratory virus infections such as influenza A are a cause of significant morbidity in hematopoietic stem cell transplant (HSCT) recipients. The clinical haracteristics and impact of novel H1N1 in this patient population is not yet well defined.
METHODS: HSCT recipients diagnosed with proven or probable H1N1 during the 2009 pandemic were identified and charts retrospectively reviewed with clinical descriptions, risk factors, diagnosis, treatments and outcomes analyzed.
RESULTS: Twenty-seven patients were identified from two medical centers. Fever and cough were the most common presenting symptoms. The incidence of influenza lower respiratory tract infection (LRTI) was 52% (14/27). Compared to patients with LRTI, those with influenza upper respiratory tract infection (URTI) were more likely to have a classic influenza-like syndrome. Those with LRTI were begun on antiviral therapy significantly later after symptom onset (3.0 days vs. 6.58 days after onset of symptoms, p=0.03; 95% CI 0.29, 6.8). Overall influenza-related 30-day mortality was 22% (6/27) and in patients with LRTI was 43 % (6/14). Chronic steroid use (>/= 20 mg/day of prednisone equivalent) at the time of presentation was associated with LRTI (p = 0.006) and mortality (p = 0.003) on univariate analysis. Five cases were hospital acquired.
CONCLUSIONS: In this first season of the novel H1N1 pandemic, infection in HSCT often presented as an atypical and severe illness with a high incidence of LRTI and high mortality.
PMID: 20708084 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20708084