[Two patients with novel influenza A virus (H1N1) pneumonia treated with steroid therapy after an incorrect diagnosis of rapid progressive interstitial pneumonia due to the negative results of a rapid-antigen test].

Abstract

We encountered 2 patients with novel influenza A (H1N1) pneumonia initially treated with steroid therapy after an incorrect diagnosis of cryptogenic organizing pneumonia and acute interstitial pneumonia, made because of atypical radiological findings and negative rapid antigen test results. After the patients were discharged, we performed reverse-transcriptase polymerase chain reaction tests for the presence of novel influenza A (H1N1); the results were positive, and we established the correct diagnosis of infection by novel influenza A (H1N1) virus pneumonia. Diagnostic clues included radiological findings similar to those of previously reported cases of novel influenza A (H1N1) virus pneumonia and an increase in similar cases due to the novel influenza A (H1N1) pandemic, suggesting that these 2 patients were also suffering from it. Similar cases of inappropriate treatment resulting from an initially incorrect diagnosis of cryptogenic organizing pneumonia or acute interstitial pneumonia may occur, and greater attention should be paid to accurate diagnosis.

• Authors: Takashi Ishiguro, Noboru Takayanagi, Tetsu Kanauchi, Toshiko Hoshi, Tsutomu Yanagisawa, Yutaka Sugita
• Journal: Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 48 Issue 9 Pg. 687-95 (Sep 2010) ISSN: 1343-3490 [Print] Japan
• PMID: 20954372 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antigens, Viral

Topics

• Aged
• Antigens, Viral (analysis)
• Diagnosis, Differential
• Humans
• Influenza A Virus, H1N1 Subtype (immunology)
• Influenza, Human (diagnosis)
• Lung Diseases, Interstitial (diagnosis)
• Male
• Middle Aged
• Pneumonia, Viral (diagnosis)