HPI: Pt is a 31 year old male with history of Hypertrophic Cardiomyopathy, IgA Deficiency who presents to OSH with 5 days of worsening shortness of breath. States that began to have symptoms of cough, fever/chills 3 days prior to admission. Symptoms similar to pneumonias in past, but this is significantly worse.
ROS: No significant wt changes. Generalized fatigue. No chest pain. Some mild chest tightness. Positive dyspnea, particularly on exertion. No abdominal pain. No N/V/D. No rashes. No lower extremity edema.
Extensive areas of pulmonary parenchymal opacification, with only a small portion of the upper lobes remaining aerated. Consistent with extensive collapse and/or pneumonia, involving both lower lobes and much of the right middle lobe and both upper lobes with hemorrhage not excluded.
Most people who get the flu (either seasonal or 2009 H1N1) will have mild illness and will recover in less than 2 weeks. They do not need medical care or antiviral drugs.
Empiric therapy and therapy should be considered in those with suspected influenza and either severe symptoms or potential for complications.
Those at higher risk for complications including:
Children younger than 2 years old;
Persons aged 65 years or older
Persons of any age with certain chronic medical or immunosuppressive conditions (blood disorders, kidney disease, cancer, chronic lung disease, liver disease, heart disease, neurologic disorders, or weakened immune systems)
Influenza vaccination is the most effective method for preventing influenza virus infection.
Beginning each September, or even earlier if vaccine is available, the flu vaccine should be offered
Both the Live, Intranasal Influenza Vaccine (LAIV) and Trivalent Inactivated Influenza Vaccine (TVIV) contain strains of influenza viruses that are antigenically equivalent to the annually recommended strains: one influenza A (H3N2) virus, one influenza A (H1N1) virus, and one influenza B virus.
The symptoms of novel H1N1 and seasonal influenza are similar: Fever, cough, headache, sore throat, anorexia, myalgias, lethargy, and sometimes vomiting and diarrhea. However, 10% to 40% of persons with novel H1N1 influenza may not be febrile
Of Boston residents hospitalized with confirmed novel H1N1 influenza, 49% had underlying asthma and 37% required ICU care
One thing that appears to be different from seasonal influenza is that adults older than 64 years do not yet appear to be at increased risk of 2009 H1N1-related complications thus far about one-third of adults older than 60 may have antibodies against this virus