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Influenza A virus infection imitating bacterial sepsis in early infancy
Insights
Influenza A virus infection can cause severe illness in infants under three months old, mimicking sepsis. Early viral diagnosis is crucial for effective management of these young patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Infants under three months old are vulnerable to severe infections.
- Influenza A virus poses a significant health risk to young children.
- Distinguishing influenza from bacterial sepsis in infants is clinically challenging.
Purpose of the Study:
- To describe the clinical presentation and laboratory findings of infants diagnosed with influenza A.
- To evaluate the utility of rapid viral diagnostic methods in this population.
Main Methods:
- Prospective data collection from 12 infants hospitalized with suspected sepsis.
- Clinical assessment including fever, lethargy, anorexia, and respiratory symptoms.
- Laboratory tests including white blood cell counts, cerebrospinal fluid analysis, and viral diagnostic testing (immunofluorescence, viral isolation).
Main Results:
- All 12 infants were diagnosed with influenza A (H3N2).
- Common symptoms included acute onset, high fever, lethargy, irritability, anorexia, and upper respiratory tract infection signs.
- Laboratory findings were largely unremarkable, with normal white blood cell counts and cerebrospinal fluid.
- Pneumonia was present in only one infant.
- Rapid viral diagnosis was successful in a majority of tested infants.
Conclusions:
- Influenza A can present as a severe febrile illness in young infants, mimicking sepsis.
- Normal laboratory findings in these cases highlight the importance of considering viral etiologies.
- Rapid viral diagnostic tools are valuable for timely and accurate diagnosis in infants with suspected sepsis.
- Increased awareness and availability of rapid diagnostics can improve the management of influenza in infants.
Abstract:
Clinical and laboratory data of 12 previously healthy infants under 3 months of age hospitalized for suspected sepsis and subsequently diagnosed as suffering from influenza A viral infection were obtained prospectively during two epidemics of influenza A/Bangkok/H3N2 epidemics. The onset of the illness was generally acute, and the infants presented with high fever, lethargy often alternating with irritability, anorexia and signs of upper respiratory tract infection. History of contact with at least one person with signs and symptoms consistent with viral disease was present in all infants. White blood cell counts were within normal limits. Only one child had pneumonia and all had normal cerebrospinal fluid findings. Viral diagnosis was made by immunofluorescent testing of nasopharyngeal specimens within several hours of admission in 7 of the 9 infants tested and was isolated within 5 days from admission in 6 of 10 infants. Increasing awareness of the possible viral etiology of acute fever along with a greater availability of rapid viral diagnosis should result in better management of these young infants.