%0 Journal Article
%T Influenza A/H1N1 septic shock in a patient with systemic lupus erythematosus. A case report
%A Konstantinos Tselios
%A Ritsa Tsioka
%A Alexandros Sarantopoulos
%A Eleni Mouloudi
%A Panagiota Boura
%J BMC Infectious Diseases
%D 2011
%I BioMed Central
%R 10.1186/1471-2334-11-358
%X In this case report, an SLE patient with viral-induced septic shock, without overt pulmonary involvement, is discussed. The patient was administered oseltamivir and supportive treatment, including wide-spectrum antibiotics, vasopressors and steroids, according to the guidelines proposed for bacterial sepsis and septic shock. She finally survived and experienced a lupus flare soon after intensive care unit (ICU) discharge.To our knowledge, this is the first case to report severe septic shock from influenza A/H1N1 virus, without overt pulmonary involvement.Infections are among the most important causes of morbidity and mortality in systemic lupus erythematosus (SLE). However, viruses are not considered to cause serious infections in these patients; they, usually, represent reactivation of herpes viruses, such as herpes simplex virus and varicella-zoster virus [1]. Nevertheless, it is reported that immunocompromised patients have an increased risk of mortality, following influenza infection [2].In the recent pandemic, influenza A H1N1 virus has been estimated to cause approximately 18.449 deaths in 214 different countries until August 1st 2010 [3]. Adult respiratory distress syndrome (ARDS), along with bacterial co-infections were the direct causes of death in most cases [4]. However, no cases of viral-induced septic shock without severe pulmonary involvement have been reported. Nevertheless, little is known about this infection in SLE patients [5]. Herein, we report a case of an SLE patient, who developed septic shock due to influenza A H1N1 infection, without acute lung injury.A 46-year old female was admitted to the hospital because of low-grade fever, sore throat and fatigue for four days; she was on clarithromycin 500 mg twice daily, as she was considered to suffer from upper respiratory tract infection by her general practitioner.The patient had a history of SLE for 24 years, antiphospholipid syndrome and autoimmune hypothyroidism. SLE was diagnosed in the backgr
%K Influenza A/H1N1
%K systemic lupus erythematosus
%K septic shock
%U http://www.biomedcentral.com/1471-2334/11/358