Ito Hiroki, Ito Sadatoshi, Hirose Takuo, Kimura Tomoyoshi, Mori Takefumi, Ito Sadayoshi
Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-Ku, Sendai, Miyagi, 983-8536, Japan.
Katta General Hospital, Shiroishi, Japan.
CEN Case Rep. 2024 Dec 11. doi: 10.1007/s13730-024-00951-6.
Seasonal influenza is prevalent globally, particularly during winter months. It is well documented that this disease causes severe, often fatal complications in hemodialysis patients. While numerous reports have focused on novel influenza viruses, there is a paucity of case reports detailing seasonal influenza viral infections in this patient population. This case presents a 71-year-old male undergoing hemodialysis who developed severe seasonal influenza A pneumonia despite receiving the influenza vaccine and early antiviral treatment. Initially presenting with fever, cough, and myalgia, the patient was diagnosed with influenza A virus infection and hospitalized due to heightened risk associated with dialysis and an elevated inflammatory response. Despite treatment with two different antiviral medications, his condition deteriorated, leading to ARDS (acute respiratory distress syndrome). The administration of steroid pulse therapy resulted in significant clinical improvement. This case underscores the severe nature of influenza virus-related illnesses in dialysis patients, even with vaccination and early antiviral intervention. It also suggests the potential benefit of early steroid pulse therapy in managing severe influenza pneumonia in high-risk individuals.
季节性流感在全球范围内流行，尤其是在冬季月份。有充分的文献记载，这种疾病会在血液透析患者中引发严重的、往往是致命的并发症。虽然众多报告聚焦于新型流感病毒，但详细描述该患者群体中季节性流感病毒感染情况的病例报告却很匮乏。本病例介绍了一名71岁接受血液透析的男性，尽管接种了流感疫苗并接受了早期抗病毒治疗，但仍患上了严重的甲型季节性流感肺炎。患者最初表现为发热、咳嗽和肌痛，因透析相关风险增加及炎症反应升高而被诊断为甲型流感病毒感染并住院。尽管使用了两种不同的抗病毒药物进行治疗，但其病情仍恶化，导致急性呼吸窘迫综合征（ARDS）。给予类固醇脉冲疗法后临床症状有显著改善。该病例强调了即使接种疫苗并进行早期抗病毒干预，流感病毒相关疾病在透析患者中的严重性。它还表明早期类固醇脉冲疗法在管理高危个体的严重流感肺炎方面可能具有益处。
