Table 2. Clinical characteristics and outcomes of 8 patients with H275Y mutation of pandemic (H1N1) 2009 virus, Seattle Cancer Care Alliance, Seattle, Washington, USA, May 1, 2009–April 30, 2010*.
| Patient no. | Symptoms of URTI | Signs of LRTI | Radiology results | Antiviral drug therapy before resistance | Co-pathogens | Outcome |
|---|---|---|---|---|---|---|
| 1 |
24 h before diagnosis:
congestion, headache |
Hypoxemia; positive BAL result
on d 5 |
Bilateral ground glass
opacity |
Oseltamivir 150 mg 2×/d
followed by peramivir |
None |
Death related to
influenza |
| 2 |
48 h before diagnosis:
congestion, wet cough, sore throat, fever (24 h) |
Hypoxemia; positive BAL result
on d 25 |
Bilateral ground glass
opacity |
Oseltamivir 150 mg 2×/d
+
rimantadine 100 mg 2×/d |
Pneumocystis
spp.
(DFA + in BAL) |
Alive |
| 3 |
5 d before diagnosis: fever (24
h), wet cough |
Hypoxemia;
positive BAL
result on d 2 |
Multiple nodules with halo
sign |
Oseltamivir 150 mg
2×/d |
Aspergillus
(PCR and GM
result positive in BAL sample); Staphylococcus
aureus; PIV3 |
Alive |
| 4 |
<24 h before diagnosis: fever
(5 d), cough |
Hypoxemia |
Bilateral infiltrates |
Oseltamivir 2 mg/kg
2×/d |
None |
Alive |
| 5 |
<24 h before diagnosis:
cough, rhinorrhea, congestion |
No |
Bronchial thickening |
Oseltamivir 150 mg
2×/d |
None |
Alive |
| 6 |
<24 h before diagnosis:
rhinorrhea, fever (24 h), cough |
No |
None |
Oseltamivir 150 mg
2×/d |
None |
Alive |
| 7 |
24 h before diagnosis: sore
throat, fever (24 h), cough |
No |
CXR stable |
Oseltamivir 75 mg 2×/d
+
rimantadine 100 mg 2×/d |
Rhinovirus
(PCR result
positive in NW sample) |
Alive |
| 8 | 24 h before diagnosis: sore throat, fever (24 h), chills | No | CXR normal | Prophylaxis: oseltamivir 45 mg 2×/d for 10 d, ended 3 d before influenza diagnosis | None | Alive |
*URTI, upper respiratory tract infection; LRTI, lower respiratory tract infection; BAL, bronchoalveolar lavage; DFA, direct immunofluorescence assay; GM, galactomanane; PIV3, parainfluenza virus 3; NW, nasal wash; CXR, chest radiograph.