Fatal Case of Pneumonia Associated with Pandemic (H1N1) 2009 in HIV-Positive Patient

DOI: 10.3201/eid1601.090930
Suggested citation for this article: Klein NC, Chak A, Chengot M, Johnson DH, Cunha BA. Fatal case of pneumonia associated with pandemic (H1N1) 2009 in HIV-positive patient [letter]. Emerg Infect Dis. 2010 Jan; [Epub ahead of print]

Fatal Case of Pneumonia Associated with Pandemic (H1N1) 2009 in HIV-Positive Patient

To the Editor: Pandemic (H1N1) 2009 first appeared in March 2009 in Mexico. In June 2009, it was declared a pandemic by the World Health Organization (1). Influenza A virus (H1N1) caused a pandemic in 1918–1919; estimated deaths were ≈100 million worldwide (2). Symptoms of pandemic (H1N1) 2009 are similar to those of seasonal influenza (fever, cough, sore throat, body aches, headache, chills, and fatigue) (3). Pandemic (H1N1) 2009 should be considered in the differential diagnosis of patients with acute febrile respiratory illness who have been in contact with persons with confirmed influenza or reside in areas where influenza has been reported (2).

Although most cases of pandemic (H1N1) 2009 in the United States have been mild, 2%–5% of infected persons have required hospitalization (2). Immunosuppressed persons, the elderly, persons with underlying lung or cardiac disease, pregnant women, persons with diabetes, obese persons, and children <5 years of age are at increased risk for this disease (4).

We report pneumonia associated with pandemic (H1N1) 2009, which resulted in respiratory and renal failure and death, in a 39-year-old HIV-positive woman. She had type 1 diabetes and a diagnosis of AIDS 7 years ago and had received highly active antiretroviral therapy. She also had an ill child at home with an influenza-like illness.

Her medical history included pleuropericardial Nocardia spp. infection, recurrent pleural effusions requiring thoracentesis, and hepatomegaly of unknown cause. Her most recent CD4 cell count was 166 cells/μL with undetectable viral load 1 month before admission. Medications prescribed included combivir, efavirenz, and trimethoprim/sulfamethoxazole but she was
Page 1 of 4

abrir aquí:
http://www.cdc.gov/eid/content/16/1/pdfs/09-0930.pdf