Table 1.
Selected characteristics and laboratory, radiologic, and neurodiagnostic results for two patients with acute neurologic complications associated with novel influenza A (H1N1)
| Patient 1 | Patient 2 | |
|---|---|---|
| Demographics | ||
| Age (years) | 26 | 29 |
| Sex | F | M |
| Ethnicity | Hispanic | Hispanic |
| Underlying medical conditions | ||
| Asthma | Yes | No |
| Diabetes | No | No |
| Immunocompromised | No | No |
| Chronic cardiovascular disease | No | No |
| Chronic renal disease | No | No |
| Neurocognitive disorder | No | No |
| Neuromuscular disorder | No | No |
| Other prior neurological conditions | No | No |
| Pregnancy | No | N/A |
| Seizure disorder | No | No |
| Other prior medical conditions | Gastroesophageal reflux | Malaria |
| Prior medications | Fluticasone, salmeterol, montelukast, nabumetone, omeprazole, albuterol, prednisone taper | None |
| Allergies | NKDA | NKDA |
| Ever a smoker | Yes (current) | No |
| BMI | 66 | 31 |
| ASA therapy | No | No |
| Clinical symptoms at presenting admission | ||
| Fever | Yes | Yes |
| Cough | Yes | Yes |
| Shortness of breath | Yes | Yes |
| Fatigue/weakness | Yes | Yes |
| Chills | Yes | No |
| Rhinorrhea | Yes | Yes |
| Myalgias | Yes | Yes |
| Headache | No | Yes |
| Sore throat | Yes | Yes |
| Vomiting | No | Yes |
| Wheezing | Yes | No |
| Diarrhea | No | No |
| Presence of neurological signs/symptoms at admission | No | No |
| Presenting admission laboratory data | ||
| Serum sodium (mmol/L) | 134 | 136 |
| Liver function tests | Elevated | Elevated |
| Blood bacterial culture | Negative | Negative |
| Urine bacterial culture | Negative | Negative |
| Viral testing and antiviral therapy | ||
| H1N1 reverse transcriptase–polymerase chain reaction positive | Yes | Yes |
| Hospitalization results | ||
| Length of hospitalization (days) | 11 | 8 days |
| Selected laboratory abnormalities during hospitalization | ||
| Sodium (Na) nadir (mmol/L) | 123 | 123 |
| Na at time of neurological presentation (mmol/L) | 126 | 126 |
| Neurologic presentation | ||
| Neurologic complication(s) diagnosed | Cerebral edema | Cerebral edema |
| Interval from respiratory illness onset to neurologic symptoms (days) | 3 | >1 week |
| Intracranial pressure at time of neurologic presentation (cm CSF) | 26 | N/A |
| Plasma creatinine at time of neurological presentation (mg/dL) | 3.93 | 5.81 |
| Creatine kinase at time of neurological presentation (U/L) | 4868 | 2935 |
| Neurodiagnostic testing | ||
| Head CT scan | Cerebral edema | Cerebral edema |
| Brain MRI | No (obese – unable to fit in scanner) | No (patient not stable for travel) |
| Placement of ICP monitoring device | EVD | None |
ASA = aminosalicylic acid, BMI = body mass index, CSF = cerebrospinal fluid, EVD = external ventricular drain, N/A = not applicable, NKDA = no known drug allergies.