New lung damage info on H1N1

[Guest guest]

H1N1 flu causes unusual damage to lungs: studies By Reuters - Thu Oct 15, 11:42

AM PDT

WASHINGTON (Reuters) - The new pandemic H1N1 flu may cause blood clots and other

unusual damage in the lungs and doctors need to be on the lookout, U.S.

researchers reported on Thursday.

Two studies published in the American Journal of Roentgenology show the need to

check X-rays and CT scans for unusual features, and also point out swine flu can

be tricky to diagnose in some of the sickest patients.

H1N1 flu is causing a pandemic, and while it is not particularly deadly, it is

sickening many younger adults and older children who usually escape the worst

effects of seasonal flu.

" It is therefore essential that clinicians be able to recognize possible cases

of pandemic H1N1 influenza in high-risk groups so that they order the

appropriate diagnostic tests, begin specific antiviral therapy, and prepare to

provide intensive supportive measures as needed, " Dr. Mollura of the

National Institutes of Health Clinical Center in land and colleagues wrote.

One middle-aged man who died was not diagnosed until after death, but unusual

findings on his X-rays may be able to help doctors save other, similar patients.

Mollura's team found irregularities called ground-glass opacities in the

patient's lungs using a CT scan. Although the patient was severely ill and had a

fever, he tested negative for flu and doctors did not treat him for it.

The man died five days after he went into the hospital and the autopsy confirmed

he had swine flu. The lung lesions seen on his CT scan matched lung damage done

by the virus, Mollura and colleagues said.

In another study in the same journal, CT scans of patients with severe cases of

swine flu showed many had pulmonary emboli, which block the arteries in the

lungs, a team at the University of Michigan found.

Anticoagulant drugs can break up these clots and save lives.

Dr. Prachi Agarwal and colleagues examined 66 patients diagnosed with H1N1, 14

of them who were in the intensive care unit. All 66 got standard X-rays, which

can show if a patient has pneumonia.

They performed enhanced X-rays known as computed tomography or CT scans on 15 of

the patients, 10 of them who were in the ICU on ventilators to help them

breathe. Five of the ICU patients had the blood clots in the lungs, Agarwal

reported

" Our study suggests that patients who are severely ill with H1N1 are also at

risk for developing pulmonary emboli, which should be carefully sought for on

contrast-enhanced CT scans, " Agarwal said in a statement.

" The majority of patients undergoing chest X-rays with H1N1 have normal

radiographs (X-rays), " she added. Pulmonary emboli are also not normally seen in

flu, she said.

" CT scans proved valuable in identifying those patients at risk of developing

more serious complications as a possible result of the H1N1 virus, and for

identifying a greater extent of disease than is appreciated on chest

radiographs. "

(Reporting by Maggie Fox; Editing by Steenhuysen and Ostemran)