Clinical and morphological features of community-acquired pneumonia during the A / H1N1 influenza epidemics

Abstract

Summary. This article presents a retrospective comparative analysis of hospitalized cases of community-acquired pneumonia (CAP) during the 2007 to 2009 years in a pneumology department of a regional hospital, Penza. This period included 2009 A / H1N1 influenza epidemics. In 2009, the number of hospitalizations increased in 1.4 times, mortality increased in 5.7 times in comparison with 2007 and 2008 years. Severe and atypical course of CAP with dry cough, prolonged fever, severe respiratory failure, bilateral multi-segmental lesions, an absence of leukocytosis and severe complications (acute respiratory failure, phlebitis, sepsis) were noted in 60.9 % of patients. CAP associated with influenza A / H1N1 was more common in patients with cardiovascular disease, obesity and differed from CAP in previous years. In 2009, outcomes of CAP were fibrosis in 43.8 % (compared to 25 % in 2008 and 21.2 % in 2007) and death in 12.5 % of cases. Pathomorphological findings were hemorrhage and microthrombosis in respiratory system, brain, and other organs.