Complications
Common complication of highly pathogenic avian influenza (HPAI) A(H5N1)virus infection.
Treatment is with antivirals as soon as possible, supplemental oxygen, and supportive therapy. Respiratory status should be monitored, and early ventilatory support considered.
This is a common complication of highly pathogenic avian influenza (HPAI) H5N1 virus infection, usually due to acute respiratory distress syndrome. Has been documented among all affected age groups.
Antiviral and supportive therapy is necessary.
The most common cause of respiratory failure.
Evidence-based, lung protective ventilation strategies are recommended.
Multi-organ failure, including renal or cardiac compromise, is a common complication of severely ill highly pathogenic avian influenza (HPAI) A(H5N1) patients.
Supportive therapy is crucial, as is targeted therapy where applicable. Management should follow evidence-based management guidelines.
Septic shock requiring vasopressor support is a common complication of highly pathogenic avian influenza (HPAI) A(H5N1) virus infection.
Treatment is supportive and should follow existing evidence-based guidelines for the management of septic shock.
Encephalitis is an uncommon complication of highly pathogenic avian influenza (HPAI) A(H5N1) virus infection, but fatal cases of central nervous system infection and detection of virus in cerebrospinal fluid have been described. A fatal case of meningoencephalitis has also been reported.
Patients have headaches, behavioural disturbances, and altered mental status, and may have seizures and coma, as a direct result of virus infection.
The underlying infection should be treated with antivirals as soon as possible, and supportive care provided as indicated.
Occurs in about 49% of patients with highly pathogenic avian influenza (HPAI) A(H5N1) virus infection reported to the World Health Organization.[37]
While superinfection with bacterial pneumonia pathogens (Staphylococcus aureus, Streptococcus pneumoniae, group A streptococcus) is well described with seasonal influenza A or B virus infections, as well as with influenza A (H1N1)pdm09 virus infection, concurrent community-acquired bacterial pneumonia with highly pathogenic avian influenza (HPAI) H5N1 virus infection has rarely been reported.
In most cases, empiric therapies for bacterial pneumonia and influenza virus infection are initiated before the HPAI A(H5N1) diagnosis is confirmed. Antibacterial therapy should follow evidence-based treatment guidelines, conform to regional standards of care, and target common community-acquired pneumonia pathogens from the region where infection occurred.
Common complication of mechanical ventilation and one of the most frequent of all healthcare-associated infections. However, it has been infrequently reported in highly pathogenic avian influenza (HPAI) A(H5N1) patients.
Evaluation and treatment should follow evidence-based guidelines.
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