Doi M, Takao S, Kaneko K, Karakawa S, Ishihara S, Awaya Y, Kuwabara M, Ishioka S, Yamakido M
Critical Care Medical Center, Prefectural Hospital of Hiroshima.
Intern Med. 2001 Jan;40(1):61-7. doi: 10.2169/internalmedicine.40.61.
We report two cases of severe bronchopneumonia due to influenza A (H3N2) virus. The severity of the disease necessitated initiation of empiric therapy based on the present illness and clinical data on admission. Both patients were improved by artificial ventilation with positive end-expiratory pressures and administration of broad spectrum antibiotics and corticosteroids before confirming the diagnosis of viral bronchopneumonia using viral culture and serological tests. Within 24 hours, influenza A (H3N2) virus was identified by amplification of the pathogen genes by reverse transcription polymerase chain reaction (RT-PCR) using the stored bronchoalveolar lavage (BAL) fluids of both cases. This suggests that a combination of detection methods of pathogens using RT-PCR and BAL fluid will facilitate determination of rational treatment aimed at influenza A virus.