Bal Chinmaya Kumar, Bhatia Vikram, Kumar Sachin, Saini Deepak, Khillan Vikas, Gupta Ekta, Rathor Neha, Choudhury Ashok, Kumar Naveen, Daman Ripu, Sarin Shiv Kumar
Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110 070, India.
Indian J Gastroenterol. 2014 Mar;33(2):178-82. doi: 10.1007/s12664-014-0443-5. Epub 2014 Jan 29.
Seasonal influenza is often unsuspected in cirrhotic patients admitted with pneumonia and acute hepatic decompensation. We report five consecutive patients with influenza A subtype H1N1 2009 strain (influenza A/H1N1/09) admitted to our intensive care unit. All had a short history of rapidly worsening respiratory symptoms, but there were no characteristic clinical or radiographic features. Secondary pulmonary infection was universal. All five patients died, despite prompt institution of oseltamivir and intensive supportive care. A high index of suspicion is needed for influenza infection among patients with decompensated cirrhosis.
肝硬化患者因肺炎和急性肝失代偿入院时，季节性流感常难以被察觉。我们报告了连续5例入住我们重症监护病房的2009年甲型H1N1流感病毒株（甲型H1N1/09流感）患者。所有患者均有迅速恶化的呼吸道症状的短病程，但无特征性临床或影像学表现。继发性肺部感染普遍存在。尽管及时给予了奥司他韦并进行了强化支持治疗，所有5例患者均死亡。对于失代偿期肝硬化患者，需要高度怀疑流感感染。
