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

Sirine A. Baltagi, Michael Shoykhet, Kathryn Felmet, Patrick M. Kochanek, Michael J. Bell

Research output: Contribution to journalArticle

86 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)179-184
Number of pages6
JournalPediatric Critical Care Medicine
Volume11
Issue number2
DOIs
StatePublished - Mar 2010
Externally publishedYes

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Pandemics
Human Influenza
Nervous System
Pediatric Intensive Care Units
Infection
Consciousness Disorders
Tertiary Healthcare
Critical Care
Neurologic Manifestations
Intensive Care Units
Electroencephalography
Seizures
Differential Diagnosis
Fever
Pediatrics

Keywords

  • Children
  • Encephalopathy/encephalitis
  • H1N1
  • Influenza A
  • Neurologic outcome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Neurological sequelae of 2009 influenza A (H1N1) in children : A case series observed during a pandemic. / Baltagi, Sirine A.; Shoykhet, Michael; Felmet, Kathryn; Kochanek, Patrick M.; Bell, Michael J.

In: Pediatric Critical Care Medicine, Vol. 11, No. 2, 03.2010, p. 179-184.

Research output: Contribution to journalArticle

Baltagi, Sirine A. ; Shoykhet, Michael ; Felmet, Kathryn ; Kochanek, Patrick M. ; Bell, Michael J. / Neurological sequelae of 2009 influenza A (H1N1) in children : A case series observed during a pandemic. In: Pediatric Critical Care Medicine. 2010 ; Vol. 11, No. 2. pp. 179-184.
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