Objective To 1) describe clinical characteristics of adult patients in Chile with severe acute respiratory infections (SARI) associated with influenza viruses, and 2) analyze virus subtypes identified in specimens collected from those patients, hospital resources used in clinical management, clinical evolution, and risk factors associated with a fatal outcome, using observational data from the SARI surveillance network (SARInet). Methods Adults hospitalized from 1 July 2011 to 31 December 2015 with influenza-associated SARI at a SARI sentinel surveillance hospital in Santiago were identified and the presence of influenza in all cases confirmed by reverse transcription polymerase chain reaction (RT-PCR), using respiratory samples. Results A total of 221 patients (mean age: 74.1 years) were hospitalized with influenza-associated SARI during the study period. Of this study cohort, 91.4% had risk factors for complications and 34.3% had been vaccinated during the most recent campaign. Pneumonia was the most frequent clinical manifestation, occurring in 57.0% of the cohort; other manifestations included influenza-like illness, exacerbated chronic bronchitis, decompensated heart failure, and asthmatic crisis. Cases occurred year-round, with an epidemic peak during autumn–winter. Both influenza A (H1N1pdm09 and H3N2) and B virus co-circulated. Critical care beds were required for 26.7% of the cohort, and 19.5% needed ventilatory assistance. Multivariate analysis identified four significant factors associated with in-hospital mortality: 1) being bedridden (adjusted odds ratio (aOR): 22.3; 95% confidence interval (CI): 3.0–164); 2) admission to critical care unit (aOR: 8.9; CI: 1.44–55); 3) Pa0 2 /Fi0 2 ratio < 250 (aOR: 5.8; CI: 1.02–33); and 4) increased serum creatinine concentration (> 1 mg/dL) (aOR: 5.47; CI: 1.20–24). Seasonal influenza vaccine was identified as a significant protective factor (aOR: 0.14; CI: 0.021–0.90). Conclusions Influenza-associated SARI affected mainly elderly patients with underlying conditions. Most patients evolved to respiratory failure and more than one-quarter required critical care beds. Clinical presentation was variable. Death was associated with host characteristics and disease-associated conditions, and vaccine was protective. Virus type did not influence outcome.

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Non-resolving pneumonia is a common clinical problem that prolongs morbidity and increases hospitalization costs. We report an 82 year-old non-smoking female who was admitted with chronic diarrhea and later developed nosocomial pneumonia. Lung infiltrates did nota neumonía que no responde a tratamiento (NNRT) es un problema relativamente frecuente entre pacientes hospitalizados que aumenta la morbimortalidad y cuya incidencia oscila entre 13 y 18% 1-3 . El estudio y manejo de estos pacientes comúnmente se fundamenta en la experiencia clínica, más que en evidencia cientí-fica. Un enfrentamiento inadecuado puede llevar a intervenciones innecesarias, aumentando los costos, estadía hospitalaria y las complicaciones.Una de las causas de la NNRT es la neumonía organizada, una entidad poco conocida, subdiagnosticada y que puede ser secundaria a múltiples causas, siendo de diagnóstico fundamentalmente histopatológico 4 . Cuando no se logra identificar una etiología se denomina neumonía organizada criptogénica (Cryptogenic Organizing Pneumonia: COP). Su potencial respuesta a corticoides, hace de esta patología un desafío para el clínico, especialmente cuando se han agotado los recursos diagnósticos y estrategias terapéuticas convencionales.Este artículo tiene como propósito dar a conocer un caso de COP que se presentó como

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