Homsi Samer, Milojkovic Natasa, Alawad Bashar, Homsi Yamen
J Ark Med Soc. 2012 Sep;109(4):62-4.
Young adults with underlying medical conditions who are infected with the H1N1 virus are at risk of quickly progressing from mild upper airways infection to severe ARDS within 4 to 5 days after the onset of the illness. Here, we report the case of a 46-year-old morbidly obese and diabetic woman infected with the H1N1 virus who developed acute bronchitis that lasted for 4 weeks and then progressed to ARDS. We discuss the month-long persistence of the H1N1 viral bronchitis and its late progression to ARDS which may reflect prolonged viral activity. Such a prolonged, rather than quick, course of deterioration can cause clinicians to misdiagnose the etiology of the ARDS and may cause the patient to receive a prolonged treatment with steroids to treat bronchitis symptoms. These steroids may cause increased viral replication and promote parenchymal involvement and the development of ARDS.
患有基础疾病的年轻成年人感染甲型H1N1流感病毒后，在发病后4至5天内有迅速从轻度上呼吸道感染发展为严重急性呼吸窘迫综合征（ARDS）的风险。在此，我们报告一例46岁的病态肥胖且患有糖尿病的女性感染甲型H1N1流感病毒的病例，该患者起初患急性支气管炎，持续了4周，随后发展为ARDS。我们讨论了甲型H1N1流感病毒引起的支气管炎持续长达一个月以及其后期发展为ARDS的情况，这可能反映了病毒活动的持续时间延长。这种病程延长而非迅速恶化的情况可能导致临床医生误诊ARDS的病因，并可能使患者接受长时间的类固醇治疗以缓解支气管炎症状。这些类固醇可能会导致病毒复制增加，促进实质器官受累及ARDS的发展。
