Eleven patients undergoing diagnostic BAL had influenza virus isolated, and in eight of these influenza was the only pathogen isolated. There were nine type A and two type В isolates. All positive cultures were obtained between December and the first week in March. Medical records were available for 9 of 11 patients. Seven of the patients were immunocompromised, but none of the patients had HIV infection and their influenza immunization status could not be determined. The median age was 52 years, with a range of 33 to 78 years (Table 3). Chest roentgenograms revealed diffuse infiltrates in five patients and lobar infiltrates in three. Five patients experienced acute respiratory failure requiring mechanical ventilation; three died. Amantadine was used in only one patient, a 33-year-old who experienced acute respiratory failure requiring mechanical ventilation; he survived. Overall, three of nine (33 percent) evaluable patients infected with influenza virus died. Canadian health & care mall Source All three had influenza A and none received amantadine therapy. Their deaths were from acute respiratory failure occurring within 5 days of diagnosis. A contributing factor to death in one patient with melanoma was sepsis from Streptococcus pneumoniae.
Rhinovirus was isolated from eight patients and was the only pathogen identified in five. Virus isolation was distributed throughout the year. The median age of the group was 41 years, ranging from 20 to 59 years. All eight patients were immunocompromised: four with solid organ transplant, one with AIDS, one with systemic lupus erythematosus, one with metastatic breast carcinoma, and one with alcoholism. Chest roentgenograms were available in seven patients. Four patients had diffuse infiltrates; two patients also were infected with Legionella pneumophila and P carinii, respectively. The remaining three patients had lobar infiltrates evidenced on a chest roentgenogram; only rhinovirus was isolated from these patients. Antiviral therapy was not prescribed for any patient. There was no mortality associated with rhinovirus infection.
Table 3—Clinical Characteristics of Patients With Influenza Isolated From Bronchoalveolar Lavage Specimen
|Age, уг/ Sex/Type*||UnderlyingDiagnosis||ChestRoentgenogram||MechanicalVentilation||Outcome|
|49/F/A||Breast cancer||Not available||No||Survived|