Case of the Month #165: Swine-origin Influenza A (H1N1) Viral Pneumonia Presenting as Crazy-paving on Computed Tomography: Case Report and Literature Review

摘要: A 35-year-old woman presented to the emergency department with a 1-week history of shortness breath, nonproductive cough, and fever. The patient was previous intravenous drug abuser known have hepatitis C human immunodeficiency virus. She not on any antiretroviral medications. On admission, she had temperature 38.7 C, blood pressure 100/50, an oxygen saturation 87% room air. Results physical examination were unremarkable, apart from scattered chest crackles. Her initial radiograph is illustrated in Figure 1. workup revealed neutropenia, lymphopenia, thrombocytopenia, elevated lactate dehydrogenase level, increased serum transaminases. Blood, nasal swab, sputum, urine cultures negative for organisms. Because patient’s deterioration over next 24 hours, subsequently intubated transferred intensive care unit (ICU). then computed tomography (CT) performed (Figure 2) underwent bronchoscopy, which bronchoalveolar lavage (BAL) sample sent evaluation. After implementing appropriate treatment based BAL results, improved gradually extubated after 2-day ICU course. discharged home 10-day hospital post-treatment 3.