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Acute Respiratory Failure in Idiopathic Pulmonary Fibrosis: Co-Infection With H1n1 And Cytomegalovirus: An Unexpected Common Denominator | OMICS International | Abstract
ISSN: 2165-7548

Emergency Medicine: Open Access
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Case Report

Acute Respiratory Failure in Idiopathic Pulmonary Fibrosis: Co-Infection With H1n1 And Cytomegalovirus: An Unexpected Common Denominator

Carmen Silvia Valente Barbas1,3*, Leonardo Lima Rocha1 Gustavo Janot Faissol de Matos1, Frederico Polito Lomar1, Christina Shiang2 and Leticia Kawano-Dourado3

1Adult Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil

2Anatomic Pathology Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil

3Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil

*Corresponding Author:
Carmen Silvia Valente Barbas
Adult Intensive Care Unit
Hospital Israelita Albert Einstein
São Paulo, Brazil
Tel: +55(11)21511233
E-mail: [email protected]

Received Date: June 21, 2013; Accepted Date: September 04, 2013; Published Date: September 06, 2013

Citation: Valente Barbas CS, Rocha LL, de Matos GJF, Lomar FP, Shiang C, et al. (2013) Acute Respiratory Failure in Idiopathic Pulmonary Fibrosis: Co- Infection With H1n1 And Cytomegalovirus: An Unexpected Common Denominator. Emergency Med 3:152. doi:10.4172/2165-7548.1000152

Copyright: © 2013 Valente Barbas CS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


We described a case of persistent influenza AH1N1 and cytomegalovirus respiratory infection in a patient with chronic interstitial lung disease and multiple bilateral pulmonary opacities. An open lung biopsy revealed diffuse organizing alveolar damage, necrotizing bronchiolitis, necrotizing pneumonia and alveolar hemorrhage, compatible with H1N1 infection as well as usual interstitial pneumonia. Diagnoses of an idiopathic CD4+ T cell lymphocytopenia and immunoglobulin G deficiency were made as an unexpected co-denominator of H1N1 and CMV persistent infection changing our treatment approach.


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