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  • Title: Clinical and Radiographic Comparison of Influenza Virus-associated Pneumonia among Three Viral Subtypes.
    Author: Ishiguro T, Takayanagi N, Kanauchi T, Uozumi R, Kawate E, Takaku Y, Kagiyama N, Shimizu Y, Hoshi T, Morita S, Sugita Y.
    Journal: Intern Med; 2016; 55(7):731-7. PubMed ID: 27041156.
    Abstract:
    OBJECTIVE: Presently, the predominant subtypes of influenza viruses in the world, except for those in local epidemics, include influenza pandemic H1N1 2009 (pH1N1), H3N2, and B viruses. There are few reports on the differences in the clinical features, radiographic findings, treatment, and outcomes of influenza virus-associated pneumonia among these three viral subtypes. The purpose of this study was to investigate whether the clinical features, radiographic findings, treatment, and outcomes differ among the viral subtypes. METHODS: We retrospectively analyzed 96 patients with influenza virus-associated pneumonia whose viral subtypes were clarified. RESULTS: Patients with pH1N1 virus-associated pneumonia tended to be young. The frequency of primary viral pneumonia differed among the virus-associated pneumonia subtypes (pH1N1, 80%; H3N2, 26.5%; and B, 31%). Patients with pH1N1 virus-associated pneumonia more frequently showed bilateral ground-glass opacities (GGOs), which affected more lobes than in patients with H3N2 and B virus-associated pneumonia. However, patients with H3N2 virus-associated pneumonia showed a higher frequency of consolidation and diffuse bronchial wall thickening than did the patients with pH1N1 virus-associated pneumonia. The severity and mortality did not differ among the three pneumonia subtypes. CONCLUSION: In the patients who developed influenza virus-associated pneumonia, those with pH1N1 virus-associated pneumonia frequently developed primary viral pneumonia resulting in bilateral and broad areas of GGOs on imaging, whereas patients with H3N2 virus-associated pneumonia frequently showed consolidation and diffuse bronchial wall thickening on pulmonary imaging.
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