Cases reported "Influenza, Human"

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1/14. Influenza-associated encephalopathy in japan: pathogenesis and treatment.

    It is estimated that more than 100 children die of influenza-associated encephalopathy (influenza encephalopathy) every year in japan. Influenza encephalopathy is distinct from Reye's syndrome. Specifically, 20% of influenza encephalopathy patients exhibit bilateral thalamic necrosis on neuroimaging, a lesion referred to as acute necrotizing encephalopathy (ANE). Influenza encephalopathy may develop by the same pathogenetic mechanisms as ANE, possibly via vasoactive substances or a process leading to vasoconstriction in the central nervous system (CNS). A novel substitution at the receptor-binding site (Tyr 137 to Phe) was reported to be found exclusively in influenza type A (H3N2) viruses isolated from patients with influenza encephalopathy, suggesting that encephalopathy may be caused by a variant influenza type A (H3N2) virus. Recently, it has been reported that cytokines may mediate the disease and that a high plasma concentration of interleukin-6 could be an indicator of progression to encephalopathy. Although it is unknown whether influenza virus invades the CNS, amantadine therapy for influenza encephalopathy has been tried in japan, in patients in whom influenza type A infection has been demonstrated by rapid antigen detection tests.
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ranking = 1
keywords = acute necrotizing, necrotizing
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2/14. influenza a virus encephalopathy with symmetrical thalamic lesions.

    During an epidemic of influenza A infection in japan, a 7-year-old boy was admitted to our hospital because of high fever, convulsions, coma, and liver dysfunction on the 2nd day of a cold-like illness. His serum CPK was markedly elevated, but there was no hyperammonaemia or hypoglycaemia. His CSF showed an increased protein level, but the cell count and glucose level were normal. CT and MRI of the brain showed symmetrical thalamic lesions, and he was diagnosed with acute necrotizing encephalopathy in childhood. He had a significant increased in antibodies to influenza A H1N1 in serum and CSF, but the CSF was negative for influenza virus using virus isolation and a polymerase chain reaction assay. CONCLUSION: Antibody production without detectable levels of influenza virus in cerebrospinal fluid suggests that virus infection occurred, but the virus did not replicate in sufficient numbers in his central nervous system. The thalamic lesion, the hallmark of acute necrotizing encephalopathy in childhood, may be initiated by a local virus infection and develop with subsequent local changes such as breakdown of the blood-brain barrier and the extravasation of blood.
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ranking = 2
keywords = acute necrotizing, necrotizing
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3/14. Influenza A-associated bronchiolitis obliterans organizing pneumonia mimicking Wegener's granulomatosis.

    We describe a patient with bronchiolitis obliterans organizing pneumonia (BOOP) requiring respiratory support and treated with corticosteroids and cytoxan for presumed Wegener's granulomatosis (WG). The diagnosis of WG was based on clinical presentation and strongly positive stains for anti-neutrophilic cytoplasmic antibodies (cANCA). The results of an open-lung biopsy were consistent with BOOP. Although BOOP has previously been described as one of the pulmonary manifestations of WG, other more specific histologic features of WG such as capillaritis or necrotizing vasculitis were lacking. Because influenza a virus was cultured from the patient's lung tissue, final assessment of the illness focused on this as the etiologic agent triggering the pulmonary syndrome. The presence of ANCA was considered to be nonspecific. The patient's condition improved with appropriate therapy for BOOP.
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ranking = 0.0040373117791532
keywords = necrotizing
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4/14. Brain MRI findings in influenza A-associated acute necrotizing encephalopathy of childhood.

    Acute necrotizing encephalopathy following influenza A is frequently reported from japan and taiwan but is very rarely seen in Western countries. We describe a 10-year-old boy with acute necrotizing encephalopathy, who developed symmetrical thalamic and brain stem lesions seen on magnetic resonance imaging (MRI). Serological confirmation of influenza A was made 2 weeks after the onset of symptoms. The child made a full recovery. This case is interesting because of its rarity in European countries, the striking brain MRI findings and the good neurological outcome.
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ranking = 5.0040373117792
keywords = acute necrotizing, necrotizing
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5/14. A case of adult influenza a virus-associated encephalitis: magnetic resonance imaging findings.

    A 27-year-old man presented with fever, convulsive seizure, and sudden impairment of consciousness. magnetic resonance imaging (MRI) abnormalities were found in the bilateral thalami, including the brain stem and white matter. The possibility of a previous influenza a virus infection was considered, and cerebrospinal fluid cells and interleukin-6 were elevated. The MRI findings closely resembled those found in cases of childhood acute necrotizing encephalopathy (ANE). The present case suggests that adult influenza a virus-associated encephalitis/encephalopathy or ANE can occur during winter influenza epidemics.
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ranking = 1
keywords = acute necrotizing, necrotizing
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6/14. Influenza B acute necrotizing encephalopathy: a case report and literature review.

    The case of a 9-year-old girl with acute encephalopathy with evidence of influenza b virus infection and bilateral basal ganglia lesions is reported. The literature on acute necrotizing encephalopathy is reviewed, and other causes of bilateral basal ganglia lesions are discussed.
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ranking = 5
keywords = acute necrotizing, necrotizing
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7/14. influenza a virus-associated acute necrotizing encephalopathy in the united states.

    During the past several years, influenza-associated acute necrotizing encephalopathy has been well-recognized in asia but has not yet been reported in the united states. We describe a 28-month-old patient who displayed the classical clinical features of acute necrotizing encephalopathy in association with a documented influenza A infection. This disease is characterized by fever, a rapid alteration in consciousness and seizures, with radiologic involvement of the bilateral thalami and cerebellum.
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ranking = 6
keywords = acute necrotizing, necrotizing
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8/14. Acute necrotizing encephalopathy of childhood associated with influenza type B virus infection in a 3-year-old girl.

    Acute necrotizing encephalopathy of childhood represents a novel entity of acute encephalophathy, predominantly affecting infants and young children living in taiwan and japan. It manifests with symptoms of coma, convulsions, and hyperpyrexia after 2 to 4 days of respiratory tract infections in previously healthy children. The hallmark of acute necrotizing encephalopathy of childhood consists of multifocal and symmetric brain lesions affecting the bilateral thalami, brainstem tegmentum, cerebral periventricular white matter, or cerebellar medulla. The etiology and pathogenesis of this kind of acute encephalopathy remain unknown, and there is no specific therapy or prevention. The prognosis is usually poor, and less than 10% of patients recover completely. We report a 3-year-old previously healthy girl presenting with acute necrotizing encephalopathy of childhood associated with influenza type B virus infection, which resulted in severe neurologic sequelae. We also review the current knowledge of the clinical, neuroimaging, and pathologic aspects of acute necrotizing encephalopathy of childhood.
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ranking = 3.0201865588958
keywords = acute necrotizing, necrotizing
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9/14. Bronchocentric granulomatosis associated with influenza-A virus infection.

    Bronchocentric granulomatosis is an unusual pathologic entity that is characterized by a necrotizing granulomatous inflammation surrounding the airways. The diagnosis is usually made retrospectively, after histopathologic examination of an open-lung biopsy or resection of a pulmonary lesion. Although the aetiology has not been fully elucidated, the current pathogenetic mechanism is considered to be an immunologic reaction against endobronchial antigens, since most patients exhibit signs of bronchial asthma, eosinophilia and allergic bronchopulmonary aspergillosis. However, non-asthmatic patients may develop bronchocentric granulomatosis without signs for endobronchial fungal infections, but probably as a consequence of other pulmonary infections. An 80-year-old female patient presented with high fever and bilateral pulmonary infiltrates and nodules. After extensive investigations and open-lung biopsy, the diagnosis bronchocentric granulomatosis was established that was possibly associated with an influenza-A virus infection. Treatment consisted of immunosuppressive drugs (prednisone and cyclophosphamide), which led to complete clinical and radiological recovery.
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ranking = 0.0040373117791532
keywords = necrotizing
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10/14. Fatal influenza A infection with staphylococcus aureus superinfection in a 49-year-old woman presenting as sudden death.

    A fatal case of influenza A infection with staphylococcus aureus superinfection in a previously healthy 49-year-old woman presenting as sudden, unexpected death is reported. autopsy revealed severe necrotizing tracheobronchitis and hemorrhagic pneumonia. Microscopic examination of the trachea and bronchi showed mucosal necrosis and a dense lympho-monocytic infiltration of all layers. The lungs showed focal hemorrhagic pneumonia. No pathological changes were detectable in the myocardium. influenza a virus was detected in bronchi and lung samples obtained during autopsy by the polymerase chain reaction (PCR) and bacterial superinfection with staphylococcus aureus was shown by culturing from tracheal, bronchial and pulmonary swabs obtained during autopsy. PCR assays for the detection of Panton-Valentine leukocidin performed from all samples were negative. This case demonstrates the need for an interdisciplinary approach towards an organism-specific diagnosis of potentially infection-related deaths undergoing a medico-legal autopsy. With improved diagnostic possibilities such as PCR and dna sequencing, forensic pathologists can, in close association with the field of microbiology, make a significant contribution to the detection of highly infectious agents which must be notified to the authorities. This will increase particularly the knowledge about the influence of these agents on sudden, unexpected deaths in outpatients.
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ranking = 0.0040373117791532
keywords = necrotizing
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