Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Sidhu, Robinder S.; Sharma, Abhinav; Paterson, Ian; Bainey, Kevin R.

doi:10.5812/cardiovascmed.31546

Cited by 20 publications

(12 citation statements)

References 17 publications

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“…This individual had likely recovered from the initial viral challenge, cleared the virus, and perhaps acquired a secondary bacterial infection [9,22]. Notably, both individuals had pericardial effusions, which in humans are rare but serious sequellae of certain viral infections [46].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous outbreaks of respiratory disease in wild chimpanzees caused by distinct viruses of human origin

Negrey

Reddy

Scully

et al. 2019

Emerging Microbes & Infections

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Respiratory viruses of human origin infect wild apes across Africa, sometimes lethally. Here we report simultaneous outbreaks of two distinct human respiratory viruses, human metapneumovirus (MPV; Pneumoviridae : Metapneumovirus ) and human respirovirus 3 (HRV3; Paramyxoviridae ; Respirovirus , formerly known as parainfluenza virus 3), in two chimpanzee ( Pan troglodytes schweinfurthii ) communities in the same forest in Uganda in December 2016 and January 2017. The viruses were absent before the outbreaks, but each was present in ill chimpanzees from one community during the outbreak period. Clinical signs and gross pathologic changes in affected chimpanzees closely mirrored symptoms and pathology commonly observed in humans for each virus. Epidemiologic modelling showed that MPV and HRV3 were similarly transmissible ( R 0 of 1.27 and 1.48, respectively), but MPV caused 12.2% mortality mainly in infants and older chimpanzees, whereas HRV3 caused no direct mortality. These results are consistent with the higher virulence of MPV than HRV3 in humans, although both MPV and HRV3 cause a significant global disease burden. Both viruses clustered phylogenetically within groups of known human variants, with MPV closely related to a lethal 2009 variant from mountain gorillas ( Gorilla beringei beringei ), suggesting two independent and simultaneous reverse zoonotic origins, either directly from humans or via intermediary hosts. These findings expand our knowledge of human origin viruses threatening wild chimpanzees and suggest that such viruses might be differentiated by their comparative epidemiological dynamics and pathogenicity in wild apes. Our results also caution against assuming common causation in coincident outbreaks.

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Section: Discussionmentioning

confidence: 99%

Simultaneous outbreaks of respiratory disease in wild chimpanzees caused by distinct viruses of human origin

Negrey

Reddy

Scully

et al. 2019

Emerging Microbes & Infections

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“…Ison et al also demonstrated abnormal ECG findings in 53%, 33%, 27%, and 23% of patients on days 1, 4, 11, and 28 after the onset of infections ( 16 ). In general, the cardiac manifestations of influenza virus infection - when present - become apparent at 4 to 9 days after the onset of flu symptoms ( 25 ); however, the study of Ison et al suggested that ECG abnormalities might be already present at an earlier time-point after the onset of infection. We did not attempt to obtain ECG data at an earlier time point in the present study in order to avoid the unnecessary spread of influenza infection to the medical staff; however, we should be aware of the possibility of a higher prevalence of ECG abnormalities at an earlier time point during the course of infection.…”

Section: Discussionmentioning

confidence: 99%

“…Although the pathogenesis of pericardial effusion in the setting of myocardial viral infection is unclear, various viruses may induce pericardial effusion ( 27 ). There are few reports on influenza virus-associated pericardial effusion ( 28 , 29 ); nevertheless, it may lead to cardiac tamponade and a fatal outcome ( 25 ). The present study indicated that influenza virus-associated pericarditis may occur in approximately 2% of patients with influenza infection; thus, we should pay attention to this pathology.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Findings of Subclinical Influenza-associated Cardiac Abnormalities among Japanese Patients

et al. 2018

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Objective Although life-threatening cardiac complications in influenza infection are rare, subclinical influenza-associated cardiac abnormalities may occur more frequently. We investigated the prevalence of subclinical cardiac findings. Methods After obtaining their written informed consent, 102 subjects were enrolled in the present study. The study subjects underwent a first set of examinations, which included electrocardiography (ECG), echocardiography, and the measurement of their cardiac enzyme levels. Those with one or more abnormal findings among these examinations were encouraged to undergo a repeat examination 2 weeks later. Results Among the 102 subjects enrolled, 22 (21.6%) were judged to have cardiac findings, including ST-T abnormalities, pericardial effusion, diastolic dysfunction, and cardiac enzyme elevation. Eighteen of these 20 subjects underwent a second screening at a median of 14 days later, and it was found that 11 of the 18 subjects were free from cardiac findings on this second examination. This suggested that the abnormalities were only transient and they therefore might have been associated with influenza. Approximately 20% of the influenza patients enrolled had cardiac findings, including ST-T segment abnormalities, pericardial effusion, and cardiac enzyme elevation. Conclusion Among the 102 patients who were studied, the cardiac findings were only mild and transient; however, physicians should be aware of influenza infection-associated cardiac abnormalities because such abnormalities may not be rare.

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“…However, adding such a case to the growing evidence of cardiovascular (CV) complications due to Influenza, the true incidence of myocardial and pericardial involvement could be underestimated. Cases of both myocarditis and pericardial effusion with or without tamponade physiology secondary to influenza have been reported [ 5 - 8 ] but in most cases of cardiac involvement, Influenza A was identified and not Influenza B [ 9 , 10 ] (as in our case).…”

Section: Discussionmentioning

confidence: 71%

Acute Influenza B Infection Presenting as Cardiac Tamponade: A Case Report

Arfaras-Melainis¹,

Cordero²,

Goyal³

et al. 2020

Cureus

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Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Cited by 20 publications

References 17 publications

Simultaneous outbreaks of respiratory disease in wild chimpanzees caused by distinct viruses of human origin

Simultaneous outbreaks of respiratory disease in wild chimpanzees caused by distinct viruses of human origin

The Prevalence and Findings of Subclinical Influenza-associated Cardiac Abnormalities among Japanese Patients

Acute Influenza B Infection Presenting as Cardiac Tamponade: A Case Report

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