Imaging Findings in a Fatal Case of Pandemic Swine-Origin Influenza A (H1N1)

Imaging Findings in a Fatal Case of Pandemic Swine-Origin Influenza A (H1N1)
AJR:193, December 2009

OBJECTIVE. Although most cases of swine-origin influenza A (H1N1) virus (S-OIV) have been self-limited, fatal cases raise questions about virulence and radiology’s role in early detection. We describe the radiographic and CT findings in a fatal S-OIV infection.
CONCLUSION. Radiography showed peripheral lung opacities. CT revealed peripheral ground-glass opacities suggesting peribronchial injury. These imaging findings raised suspicion of S-OIV despite negative H1N1 influenza rapid antigen test results from two nasopharyngeal swabs; subsequently, those results were proven to be false-negatives by reverse transcriptase polymerase chain reaction. This case suggests a role for CT in the early recognition
of severe S-OIV.

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