Analysis of cases of severe respiratory failure in children with influenza (H1N1) 2009 infection in Japan

Abstract

Influenza (H1N1) 2009 occurred in Mexico in April 2009, quickly spread around the world, and was found in Japan in May. Many pediatric patients experienced encephalopathy, acute respiratory distress syndrome, and severe pneumonia. The subjects of this study were 31 pediatric patients who needed mechanical ventilation due to respiratory failure caused by influenza (H1N1) 2009 as reported to the Emergency Medical Information Center of the Japan Pediatric Society in Kanagawa Prefecture in Japan from August 1 to December 31, 2009. The diagnosis of influenza (H1N1) 2009 infection was based on positive results of a real-time polymerase chain reaction. No patient was diagnosed as having a bacterial infection. The average arterial PaO2/FiO2 ratio was significantly decreased to 126. Atelectasis was revealed by chest X-ray in 90.3% of subjects. There was one plastic bronchitis patient. Anti-influenza drugs were used at an average of 14.9 h after onset. Five patients showed abnormal behavior as a complication of encephalopathy. We found that respiratory failure progressed rapidly. The type of respiratory failure was oxygenation failure. It was helpful to attempt to remove more sputum in these cases. Pediatric patients with respiratory failure from influenza (H1N1) 2009 should be carefully monitored for the onset of encephalopathy.

Plastic bronchitis: Three cases caused by influenza B virus Yamagata lineage

“…Plastic bronchitis is a rare and life‐threatening disorder characterized by production of bronchial casts and development of acute respiratory failure. It is a well‐known complication of influenza virus AH1pdm09 infection . Kim et al .…”

Plastic bronchitis arising from solitary influenza B infection: A report of two cases in children

“…Influenza A has recently been identified for its association with PB, especially during the recent 2009 outbreak of the H1N1 influenza A pandemic in Asia and Mexico [4][5][6][7][8][9][10][11]. Children with influenza A infection can frequently develop acute pulmonary complications and sequelae such as pneumonia and acute respiratory failure when acutely infected.…”

Detection of Human Bocavirus 2 DNA from a Girl with Plastic Bronchitis

“…HBoV2 DNA was detected from the intratracheal aspirate as well as influenza B DNA. At least seven cases of plastic bronchitis have been reported to be associated with influenza A (H1N1) 2009 virus infection [3]. On the other hand, there has been no report of plastic bronchitis being associated with influenza B virus infection except for one case that had recurrent plastic bronchitis with influenza A (H1N1) 2009 and influenza B virus infections [4].…”