Fatal Avian Influenza A (H5N1) in a Child Presenting with Diarrhea Followed by Coma
Menno D. de Jonga b, Bach Van Camc, Phan Tu Quic, Vo Minh Hiend, Tran Tan Thanhb, Nguyen Bach Huec, Marcel Belde, Le Thi Phuongf, Truong Huu Khanhc, Nguyễn Văn Vĩnh Châud, Tran Tinh Hiend, Do Quang Hab, Jeremy Farrarb
- aOxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- bOxford University Clinical Research Unit, Hospital for Tropical Diseases
- cPaediatric Hospital Number One
- dHospital for Tropical Diseases
- eAcademic Medical Center, Amsterdam
- fDong Thap Hospital, Cao Lanh, Vietnam
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Abstract
In southern Vietnam, a four-year-old boy presented with severe diarrhea, followed by seizures, coma, and death. The cerebrospinal fluid contained 1 white cell per cubic millimeter, normal glucose levels, and increased levels of protein (0.81 g per liter). The diagnosis of avian influenza A (H5N1) was established by isolation of the virus from cerebrospinal fluid, fecal, throat, and serum specimens. The patient's nine-year-old sister had died from a similar syndrome two weeks earlier. In both siblings, the clinical diagnosis was acute encephalitis. Neither patient had respiratory symptoms at presentation. These cases suggest that the spectrum of influenza H5N1 is wider than previously thought.
TL;DRIn southern Vietnam, a four-year-old boy presented with severe diarrhea, followed by seizures, coma, and death, and the clinical diagnosis was acute encephalitis, suggesting that the spectrum of influenza H5N1 is wider than previously thought. (Semantic Scholar)