Summary
Definition
History and exam
Key diagnostic factors
- cough
- influenza-like illness
- dyspnea
- fever
- rales, rhonchi
- wheeze
- decreased breath sounds
- tachypnea
Other diagnostic factors
- abdominal pain, vomiting, diarrhea
- altered mental status
- seizures
Risk factors
- close contact with infected birds
- recent travel to an HPAI-H5N1 virus infected country
- environmental exposure to H5N1 virus
- close contact with infected humans
- laboratory work with H5N1 virus
Diagnostic investigations
1st investigations to order
- CBC with differential
- LFTs
- chest x-ray
- pulse oximetry
- sputum Gram stain
- sputum and blood bacterial culture
- reverse transcription polymerase chain reaction (RT-PCR)
Investigations to consider
- viral culture
Treatment algorithm
close contact of confirmed or probable case
suspected or probable or confirmed infection
Contributors
Authors
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
Disclosures
TMU declares that he has no competing interests.
Acknowledgements
Dr Timothy M. Uyeki would like to gratefully acknowledge Dr Justin R. Ortiz, a previous contributor to this topic.
Disclosures
JRO declares that he has no competing interests.
Peer reviewers
Waleed Javaid, MD, FACP, FIDSA
Associate Professor
Medical Director of Infection Control
Infectious Disease
Department of Medicine
SUNY Upstate Medical University
Syracuse
NY
Disclosures
WJ declares that he has no competing interests.
An De Sutter, MD, PhD
Associate Professor
Department of General Practice and Primary Health Care
Ghent University
Belgium
Disclosures
ADS declares that she has no competing interests.
Nayer Khazeni, MD, MS
Assistant Professor
Pulmonary & Critical Care Medicine
Associate
Center for Health Policy/Center for Primary Care & Outcomes Research
Stanford University School of Medicine
Stanford
CA
Disclosures
NK declares that she has no competing interests.
Differentials
- Coronavirus disease 2019 (COVID-19)
- Community-acquired pneumonia
- Atypical pneumonia
More DifferentialsGuidelines
- 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
- Guidelines for the clinical management of severe illness from influenza virus infections
More GuidelinesPatient leaflets
Flu
Pneumonia
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