To present a case of severe pneumonia and acute respiratory distress syndrome (ARDS) in a young woman infected with avian influenza A (H10N3).
Approach:
Case Presentation: A 23-year-old female with no significant past medical history developed severe pneumonia and ARDS after exposure to infected poultry. She was admitted to the hospital with high fever, cough, and sputum production.
Diagnostic Workup: Chest CT revealed bilateral pneumonia. Laboratory tests indicated elevated inflammatory markers, but cultures for bacterial infections were negative. Metagenomic sequencing identified influenza virus and Candida albicans.
Treatment: Empirical antimicrobial and antiviral therapies were initiated, including adjustments based on the identification of H10N3. The patient required mechanical ventilation and veno-venous ECMO due to severe hypoxemia.
Outcome: The patient tested positive for H10N3 and was transferred for specialized care. After intensive treatment, she recovered and was discharged approximately three months later.
Key Findings:
The patient was infected with avian influenza A (H10N3), a rare subtype with only three previous human cases reported.
Metagenomic sequencing was crucial in identifying the H10N3 virus despite negative standard cultures.
Phylogenetic analysis showed the strain was closely related to another human case of H10N3.
Interpretation:
Limitations:
The study is based on a single case, limiting generalizability.
Lack of definitive subtyping from metagenomic sequencing due to insufficient sequence counts.
