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Published on: September 19, 2025
Radiographic study of severe Influenza-A (H1N1) disease in children
Cailei Zhao1, Yungen Gan, Jie Sun
1Department of Radiology, Shenzhen Children's Hospital, Futian District, Shenzhen 518026, China.
Insights
Severe Influenza-A (H1N1) in children progresses rapidly, showing characteristic radiographic findings similar to ARDS. Some patients developed neurological complications like acute necrotizing encephalopathy.
Area of Science:
- Pediatric Radiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Severe Influenza-A (H1N1) poses a significant threat to pediatric populations.
- Understanding the radiographic manifestations is crucial for timely diagnosis and management.
- Pediatric intensive care units (PICUs) often manage these severe cases.
Purpose of the Study:
- To characterize the radiographic findings in pediatric patients with severe Influenza-A (H1N1).
- To correlate imaging findings with disease progression and outcomes.
Main Methods:
- Retrospective analysis of chest X-ray, CT, and MRI data.
- Inclusion of 29 pediatric patients admitted to the ICU for severe Influenza-A (H1N1).
- Review of cranial CT and MRI for patients with neurological symptoms.
Main Results:
- Rapid disease progression observed within the first 2-3 days.
- All patients showed increased solid and interstitial lung lesions on initial X-rays.
- Lesion absorption occurred by day 4, with significant resolution by day 15 in most cases.
- Complications included delayed recovery (27.6%), pulmonary fibrosis (10.3%), and mortality (10.3%).
- Neurological symptoms were associated with abnormalities in the thalamus in 3 of 8 patients.
Conclusions:
- Severe pediatric Influenza-A (H1N1) typically shows rapid progression in the initial 3 days.
- Radiographic findings are largely consistent with acute respiratory distress syndrome (ARDS).
- A subset of patients experienced severe complications, including acute necrotizing encephalopathy and plastic bronchitis.
Objective:
To characterize the radiographic findings of pediatric patients with severe Influenza-A (H1N1) disease.
Methods:
A retrospective study of data from chest X-ray, CT and MRI exam of 29 pediatric patients treated in intensive care unit for severe Influenza-A (H1N1) disease.
Results:
Disease developed quickly at early stage. Here are four types of radiographic findings. The disease continued to progress for 2-3 days and X-ray showed that all 29 patients had increased solid lesions with the existence of interstitial lesions. Four days later, all lung lesions showed absorption to certain degree. Fifteen days later, X-ray and CT showed complete or significant absorption in 19 cases (85.5%); delayed recovery was identified in 8 cases (27.6%), pulmonary fibrosis was found in 3 cases (10.3%), and 3 patients (10.3%) died. But the latter identified more lesions. Cranial CT and MRI were performed for 8 patients who had neurological symptoms. Of them, 3 cases (10.3%) were abnormal, showed symmetrical long T1 and T2 signal shadow in bilateral thalamus and longer T1 and T2 signals in the between. 3 cases had autopsy completed.
Conclusion:
The severe Influenza-A (H1N1) among children progression was generally rapid in the first 3 days. The overall radiographic findings are similar to acute respiratory distress syndrome (ARDS). A small portion of the patients occurred acute necrotizing encephalopathy and plastic bronchitis.
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