Influenza in Patients with Human Immunodeficiency Virus Infection: Results (Part 2)

In: Influenza

20 Nov 2012

Influenza in Patients with Human Immunodeficiency Virus Infection: Results (Part 2)Review of the medical record indicated that none of the patients had received influenza vaccine in the 1988-1989 season. No patients were receiving zidovudine or other antiviral medications at the time of initial clinical examination.
Symptoms of fever and/or cough began a median of six days (range, 2 to 21 days) before the patients came to medical attention (Table 2). Cough (productive in four patients), shortness of breath, subjective fever, headache, and nausea were present in the majority of patients (Fig 1). Fever (temperature >=38.5°C), tachypnea (respirations >20/min), and abnormalities on lung auscultation (rales, rhonchi, or wheezing) were each present in five patients. Median duration of fever was 7.5 days (range, five to 21 days). Two patients had a previous diagnosis of asthma (Table 1) — buy asthma inhaler; wheezing was detected in the lungs of both individuals at the time of admission to the hospital; however, the clinical course of influenzal illness was not noticeably altered. The peripheral leukocyte count ranged from 5,300 to 10,400/cu mm (median, 6,650/ cu mm), while median arterial oxygen tension on room air was 70.5 mm Hg (Table 2).

Table 2—Clinical Presentation of Lower Respiratory Tract Influenza Infection in HIV-Infected Patients 

Patient No./Age, yr

Duration of Symptoms Prior to Evaluation, Days

Initial PcVInitial P(A-a)Oa,* mm Hg

Length of Follow-up, t Days

Symptoms at Follow-up

1/28

2

68/47

17

Productive cough

2/41

5

80/51

23

Systemic only

3/29

21

108/6

23

Dry cough

4/29

14

73/27

58

Productive cough

5/42

4

62/51

40

Productive cough

6/42

7

56/55

29

Headaches

Figure_1

Figure 1. Presenting symptoms in HIV-infected patients with influenza virus infection. 


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