Chulalongkorn Medical Journal


Objective : To study the clinical presentations and outcomes of 2009 influenza A (H1N1) pneumonia children at King Chulalongkorn Memorial Hospital. Setting : Department of Pediatrics, King Chulalongkorn Memorial Hospital. Research design : Descriptive study. Patients Pediatric patients aged 1 month - 18 years who were admitted due to H1N1 influenza pneumonia between June 2009 - March 2010. Methods : All the pediatric patients with pneumonia who had laboratory confirmation of 2009 influenza A (H1N1) infection by positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay for H1N1 influenza A virus in their nasopharyngeal aspirates or combined nasal and throat swabs were studied. Their demographic data, clinical presentations, laboratory results, radiological findings and clinical outcomes were analyzed. Results : There were 37 patients with confirmed 2009 influenza A (H1N1) pneumonia during the study period. Male: female was 1.3: 1. The mean age was 6.4 ± 4.7 years (ranged 2 months - 16 years). Twenty-one patients (56.8%) had underlying diseases. Chronic lung disease and hematologic malignancy were the two most common underlying conditions. Only 43.2% of the patients (16/37 cases) had contact history and 7 cases got the infection while being in the hospital. The most common presenting symptoms were fever and cough (94.6%). Most of the patients had had fever with a mean temperature of 38.6 ± 0.9C (ranged 36.3 - 40.4C) for 50.0 ± 35.8 hours prior to hospitalization or diagnosis. The mean white blood cell count were 7,671 ± 623 cells/mm.3 The most common chest X-ray finding was perihilar interstitial infiltration (62.2%) while patchy infiltration was noted in 13.5% of the patients. Ten cases (27%) had hypoxemia and 4 cases (10.8%) with underlying conditions developed into acute respiratory failure. Two patients (5.4%) died due to ARDS and severe sepsis. Conclusion : Fever and cough with perihilar infiltrations were the most common clinical presentations of 2009 influenza A (H1N1) pneumonia in children admitted at King Chulalongkorn Memorial Hospital during the pandemic period. Respiratory failure occurred in patients with underlying diseases and accounted for 10.8% leading to a mortality rate of 5.4%. ARDS and superimposed bacterial infections were the major causes of death in this study.



First Page


Last Page




To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.