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Title: Clinical Course of Avian Influenza A (H5N1) in Patients at the Persahabatan Hospital, Jakarta, Indonesia, 2005-2008
Authors: Mukhtar Ikhsan
Priyanti Z. Soepandi
Erlina Burhan
Hadiarto Mangunnegoro
Arifin Nawas
et al
Keywords: Research Subject Categories::MEDICINE
Issue Date: Sep-2010
Publisher: American College of Chest Physicians
Series/Report no.: Chest;2644
Abstract: Limited understanding of the presentation and course of influenza A(H5N1) infec- tion in humans hinders evidence-based management. We reviewed the case records of patients admitted to the Persahabatan Hospital (RSP), Jakarta, Indonesia, with influenza A(H5N1) confirmed by real-time polymerase chain reaction. Twenty-two previously well patients, aged 3 to 47 years (median 24.5 years), were identified. Risk factors for death (univariate analysis) included: (1) increased D-dimers, (2) hyperglycema, (3) increased urea, (4) more extensive chest radiograph shadowing, and (5) lower admission oxygen saturation. Early diagnosis and effective treatment of human influenza A(H5N1) infection remains challenging. Most patients were referred late with advanced disease. Oseltamivir had limited clinical impact. Elevated D-dimer levels, consistent with fibrinolysis, and hyperglycemia warrant more research to determine their underlying mechanisms and optimal treatment
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