期刊
NEUROLOGY
卷 79, 期 14, 页码 1474-1481出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e31826d5ea7
关键词
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资金
- NSW Department of Health
- National Health and Medical Research Council (NHMRC) H1N1 [633028]
- NHMRC [402784, 457084]
- Creswick Foundation
- NHMRC Career Development Fellowship [1016272]
- Discipline of Paediatrics and Child Health and Faculty of Medicine, University of Sydney
- Children's Hospital at Westmead
- Royal Australasian College of Physicians
- Roche
- National Health and Medical Research Council (NHMRC)
- CSL Biotherapies
- Sanofi Pasteur
- Baxter
- GlaxoSmithKline
- GSK
- Wyeth
- Merck
- CSL
- The Children's Hospital at Westmead
Objective: We sought to determine the range and extent of neurologic complications due to pandemic influenza A (H1N1) 2009 infection (pH1N1'09) in children hospitalized with influenza. Methods: Active hospital-based surveillance in 6 Australian tertiary pediatric referral centers between June 1 and September 30, 2009, for children aged <15 years with laboratory-confirmed pH1N1'09. Results: A total of 506 children with pH1N1'09 were hospitalized, of whom 49 (9.7%) had neurologic complications; median age 4.8 years (range 0.5-12.6 years) compared with 3.7 years (0.01-14.9 years) in those without complications. Approximately one-half (55.1%) of the children with neurologic complications had preexisting medical conditions, and 42.8% had preexisting neurologic conditions. On presentation, only 36.7% had the triad of cough, fever, and coryza/runny nose, whereas 38.7% had only 1 or no respiratory symptoms. Seizure was the most common neurologic complication (7.5%). Others included encephalitis/encephalopathy (1.4%), confusion/disorientation (1.0%), loss of consciousness (1.0%), and paralysis/Guillain-Barre syndrome (0.4%). A total of 30.6% needed intensive care unit (ICU) admission, 24.5% required mechanical ventilation, and 2 (4.1%) died. The mean length of stay in hospital was 6.5 days (median 3 days) and mean ICU stay was 4.4 days (median 1.5 days). Conclusions: Neurologic complications are relatively common among children admitted with influenza, and can be life-threatening. The lack of specific treatment for influenza-related neurologic complications underlines the importance of early diagnosis, use of antivirals, and universal influenza vaccination in children. Clinicians should consider influenza in children with neurologic symptoms even with a paucity of respiratory symptoms. Neurology (R) 2012;79:1474-1481
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