VA MTC 5/19: Double Flu!

Today for MTC, one of our awesome second year residents, Jessica Hansen, presented a fascinating case of a patient who presented with 1 week of shortness of breath. His past medical history included COPD, heart failure, and a recent surgery making his initial differential diagnosis very broad: COPD exacerbation, volume overload, PE, and pneumonia.

The patient was febrile and hypoxemic on presentation, and his chest x-ray revealed bilateral, right > left, heterogenous opacities. We took the opportunity to review the approach to reading chest x-rays for the brand new MS3s!

The patient’s initial work-up revealed he was positive for both Influenza A and Haemophilus influenza! Double Flu! With help from our expert discussant and ID fellow, Mike Doud, we discussed indications for the treatment of viral influenza.

  • Influenza antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influence who:
    • is hospitalized
    • has severe, complicated, or progressive illness, or
    • is at higher risk for influenza complications (Age > 65, asthma, chronic lung disease, heart disease, kidney disease, liver disease, BMI > 40…)
  • Antiviral treatment also can be considered for any previously healthy, symptomatic outpatient not at high risk for influenza complications, who is diagnosed with confirmed or suspected influenza, if treatment can be initiated within 48 hours of illness

Thank you so much to Mike Doud for joining us today and to Jessica Hansen for sharing this awesome case!

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