Fatal 2009 pandemic influenza A (H1N1) in a bone marrow transplant recipient

  • Anselmo Abdo Center for Medical and Surgical Research (CIMEQ), Havana, Cuba
  • Carlos Alfonso Center for Medical and Surgical Research (CIMEQ), Havana, Cuba
  • Guillermo Diaz Center for Medical and Surgical Research (CIMEQ), Havana, Cuba
  • Mario Wilford Center for Medical and Surgical Research (CIMEQ), Havana, Cuba
  • Maykel Rocha Center for Medical and Surgical Research (CIMEQ), Havana, Cuba
  • Niurka Verdecia Center for Medical and Surgical Research (CIMEQ), Havana, Cuba
Keywords: H1N1, influenza, bone marrow transplant, necropsy, immunosuppression, oseltamivir.

Abstract

Conditions characterized by immunosuppression have been recently reported as risk factors for severe novel swine-origin influenza A (H1N1) virus (S-OIV) infection during the current 2009 pandemic.  We report clinical and virological findings, antiviral therapy, and post-mortem study of S-OIV in an adult bone marrow transplant recipient. The viral genome was amplified by real time reverse transcriptase polymerase chain reaction (RT-PCR) from a nasopharyngeal swab specimen. The patient developed acute respiratory distress syndrome, septic shock, and eventually succumbed with a severe pulmonary haemorrhage. To the best of our knowledge, the entire clinical/therapy management and pathological examination in a transplant recipient infected with the S-OIV has not been previously documented. The fatal ending in this bone marrow transplant recipient supports recommendations that call for education measures, S-OIV vaccination, early diagnosis and aggressive treatment in the transplant population.

Author Biographies

Anselmo Abdo, Center for Medical and Surgical Research (CIMEQ), Havana, Cuba

MD, PhD

Intensive Care Unit

Carlos Alfonso, Center for Medical and Surgical Research (CIMEQ), Havana, Cuba

MD

Pathology Department

Guillermo Diaz, Center for Medical and Surgical Research (CIMEQ), Havana, Cuba

MD

Intensive Care Unit

Mario Wilford, Center for Medical and Surgical Research (CIMEQ), Havana, Cuba

MD

Haematology Unit

Maykel Rocha, Center for Medical and Surgical Research (CIMEQ), Havana, Cuba

MD

Intensive Care Unit

Niurka Verdecia, Center for Medical and Surgical Research (CIMEQ), Havana, Cuba

BSc

Microbiology Department

Published
2010-07-19
How to Cite
1.
Abdo A, Alfonso C, Diaz G, Wilford M, Rocha M, Verdecia N (2010) Fatal 2009 pandemic influenza A (H1N1) in a bone marrow transplant recipient. J Infect Dev Ctries 5:132-137. doi: 10.3855/jidc.1066
Section
Case Reports