Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- cough
- influenza-like illness
- dyspnea
- fever
- decreased breath sounds
- tachypnea
Outros fatores diagnósticos
- vomiting, diarrhea
- altered mental status
Fatores de risco
- environmental exposure to Asian lineage A(H7N9) virus
- close contact with infected humans
- laboratory work with A(H7N9) virus
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC with differential
- LFTs
- chest x-ray
- pulse oximetry
- sputum Gram stain
- sputum and blood bacterial culture
- reverse transcription polymerase chain reaction (RT-PCR)
Investigações a serem consideradas
- viral culture
Algoritmo de tratamento
close contact of confirmed or probable case
suspected or probable or confirmed infection
Colaboradores
Autores
Jake Dunning, BSc (Hons), MBBS, MRCP, PhD
Consultant and Honorary Clinical Associate Professor in Infectious Diseases and High Consequence Infectious Diseases
Royal Free London NHS Foundation Trust
London
UK
Declarações
JD declares that he has no competing interests.
Timothy M. Uyeki, MD, MPH, MPP
Chief Medical Officer
Influenza Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
Atlanta
GA
Declarações
TMU was a member of the Guideline Development Group for the World Health Organization Standard Guidance for the Clinical Management of Severe Influenza in 2017-2019, with recommendations posted by the World Health Organization in 2022. TMU was a co-chair for the Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza, which published in 2019. He is also the author of several papers cited in this topic.
Agradecimentos
Dr Jake Dunning and Dr Timothy M. Uyeki would like to gratefully acknowledge Dr Justin R. Ortiz, a previous contributor to this topic.
Declarações
JRO is a member of the International Council on Adult Immunization and the scientific community for the Global Influenza Hospitalization Surveillance Network.
Revisores
Rob Fowler, MDCM, MSc
Senior Scientist
Sunnybrook Health Sciences Centre
Toronto
Ontario
Canada
Declarações
RF declares that he has no competing interests.
Nelson Lee, MD, FRCP(Lond.), FRCP(Edin.)
Professor
Division of Infectious Diseases
Faculty of Medicine and Dentistry
University of Alberta
Edmonton
Alberta
Canada
利益声明
NL declares that he has no competing interests.
Michael Ison, MD, MS
Professor
Division of Infectious Diseases
Division of Organ Transplantation
Northwestern University Feinberg School of Medicine
Chicago
IL
利益声明
MI declares that he received research support, paid to Northwestern University, from Beckman Coulter, Chimerix, and Gilead; is a paid consultant for Celltrion, Chimerix, Farmark, Genentech/Roche, Toyama/MediVector, Seqirus, and Shionogi; and is a member of the DSMB for GlaxoSmithKline and Shionogi.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Centers for Disease Control and Prevention. Interim guidance on testing and specimen collection for patients with suspected infection with novel influenza A viruses with the potential to cause severe disease in humans. Jun 2023 [internet publication].全文
UK Health Security Agency. Avian influenza: guidance, data and analysis. Jun 2023 [internet publication].全文
Centers for Disease Control and Prevention. Interim guidance for infection control within healthcare settings when caring for confirmed cases, probable cases, and cases under investigation for infection with novel influenza A viruses associated with severe disease. Mar 2022 [internet publication].全文
Centers for Disease Control and Prevention. Interim guidance on follow-up of close contacts of persons infected with novel influenza A viruses and use of antiviral medications for chemoprophylaxis. Mar 2022 [internet publication].全文
Centers for Disease Control and Prevention. Interim guidance on influenza antiviral chemoprophylaxis of persons exposed to birds with avian influenza A viruses associated with severe human disease or with the potential to cause severe human disease. Mar 2022 [internet publication].全文
World Health Organization. Guidelines for the clinical management of severe illness from influenza virus infections. 2022 [internet publication].全文
Centers for Disease Control and Prevention. Interim guidance on the use of antiviral medications for treatment of human infections with novel influenza A viruses associated with severe human disease. Mar 2022 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Coronavirus disease 2019 (COVID-19)
- Community-acquired pneumonia
- Atypical pneumonia
更多 鉴别诊断指南
- Interim guidance on testing and specimen collection for patients with suspected infection with novel influenza A viruses with the potential to cause severe disease in humans
- Avian influenza: guidance, data and analysis
更多 指南患者教育信息
Flu
Pneumonia
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