Angela P. Campbell, MD, MPH; Shevin T. Jacob, MD, MPH; Jane Kuypers, PhD; Anna Wald, MD, MPH; Janet A. Englund, MD; Lawrence Corey, MD; Michael Boeckh, MD
Note: Drs. Campbell and Jacob contributed equally to this article.
Acknowledgment: The authors thank Christi Dahlgren and Deborah Reyes for assistance compiling clinical and laboratory data; Anne Cent, Nancy Wright, Patricia Nguyen for specimen processing, testing, and laboratory expertise; and Debra Mattson for critical review of the manuscript. Biocryst Pharmaceuticals provided peramivir under emergency investigational new drug status.
Grant Support: By the National Institutes of Health (grants CA18029, HL081595, K23HL091059, L40AI071572, K24AI071113, and K24HL093294).
Potential Conflicts of Interest: Dr. Campbell has received grant support from MedImmune. Dr. Jacob received grant support from Pfizer. Dr. Wald received grant support from Roche Pharmaceuticals and GlaxoSmithKline. Dr. Englund has received grant support from MedImmune, Adamas Pharmaceuticals, and Novartis. Dr. Boeckh received grant support from Adamas Pharmaceuticals and Roche Pharmaceuticals, is a consultant for Roche and Novartis, and has received speaking fees from Roche.
Campbell A., Jacob S., Kuypers J., Wald A., Englund J., Corey L., Boeckh M.; Respiratory Failure Caused by 2009 Novel Influenza A/H1N1 in a Hematopoietic Stem-Cell Transplant Recipient: Detection of Extrapulmonary H1N1 RNA and Use of Intravenous Peramivir. Ann Intern Med. 2010;152:619-620. doi: 10.7326/0003-4819-152-9-201005040-00022
Download citation file:
Published: Ann Intern Med. 2010;152(9):619-620.
Background: Data on the manifestations and optimum management of H1N1 infection in immunocompromised patients are sparse (1, 2).
Objective: To report a case of H1N1-associated pneumonia in a hematopoietic stem-cell transplant recipient with extrapulmonary H1N1 RNA detection who was treated with intravenous peramivir.
Case Report: A woman in her 40s (body mass index, 31.8 kg/m2) with multiple myeloma had outpatient autologous hematopoietic stem-cell transplantation with myeloablative conditioning in May 2009. Two days after transplantation, she was hospitalized with fever, nausea, diarrhea, and minimally productive cough. Chest radiography was normal, neutrophil count was 1.42 × 109 cells/L, and no lymphocytes were present. Despite receiving empirical broad-spectrum antibiotics, the patient developed increased tachypnea and hypoxia. Chest computed tomography on hospital day 3 showed bilateral ground-glass opacities with central nodules. Nasal swab was positive for influenza A/H1N1 by a real-time RT-PCR assay developed at our center by using primers and a probe targeting a 102–base pair fragment of the hemagglutinin gene.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only