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Pediatr Crit Care Med. 2010 Mar;11(2):179-84. doi: 10.1097/PCC.0b013e3181cf4652.

Neurological sequelae of 2009 influenza A (H1N1) in children: a case series observed during a pandemic.

Author information

1
Department of Critical Care Medicine and the Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Abstract

OBJECTIVE:

To outline a series of cases demonstrating neurologic complications in children with Influenza infection. The ongoing 2009 influenza A (H1N1) presents significant challenges to the field of pediatric critical care and requires increased awareness of new presentations and sequelae of infection. Since World Health Organization declared a H1N1 pandemic, much attention has been focused on its respiratory manifestations of the illness, but limited information regarding neurologic complications has been reported.

DESIGN:

Case series.

SETTING:

Pediatric intensive care unit of a tertiary care medical facility.

PATIENTS:

Four children admitted to the pediatric intensive care unit between March and November 2009 at the Children's Hospital of Pittsburgh with altered mental status and influenza infection.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The clinical course was extracted by chart review and is summarized. All children demonstrated a coryzal prodrome, fever, and altered level of consciousness at admission, and one child presented with clinical seizures. Diagnostic studies performed to establish a diagnosis are summarized. All children had abnormal electroencephalograms early in their intensive care unit course and 50% had abnormal imaging studies. All children survived but 50% had neurologic deficits at hospital discharge.

CONCLUSION:

We conclude that 2009 influenza A (H1N1) can cause significant acute and residual neurologic sequelae. Clinicians should consider Influenza within a comprehensive differential diagnosis in children with unexplained mental status changes during periods of pandemic influenza.

PMID:
20081552
DOI:
10.1097/PCC.0b013e3181cf4652
[Indexed for MEDLINE]
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