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Previous Volume 352:686-691 February 17, 2005 Number 7 Next

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SUMMARY

In southern Vietnam, a four-year-old boy presented with severe diarrhea, followed by seizures, coma, and death. The cerebrospinal fluid contained 1 white cell per cubic millimeter, normal glucose levels, and increased levels of protein (0.81 g per liter). The diagnosis of avian influenza A (H5N1) was established by isolation of the virus from cerebrospinal fluid, fecal, throat, and serum specimens. The patient's nine-year-old sister had died from a similar syndrome two weeks earlier. In both siblings, the clinical diagnosis was acute encephalitis. Neither patient had respiratory symptoms at presentation. These cases suggest that the spectrum of influenza H5N1 is wider than previously thought.

Source Information

From the Oxford University Clinical Research Unit, Hospital for Tropical Diseases (M.D.J., T.T.T., D.Q.H., J.F.), Paediatric Hospital Number One (B.V.C., P.T.Q., N.B.H., T.H.K.), and the Hospital for Tropical Diseases (V.M.H., N.V.V.C., T.T.H.) — all in Ho Chi Minh City, Vietnam; Academic Medical Center, Amsterdam (M.B.); and Dong Thap Hospital, Cao Lanh, Vietnam (L.T.P.).

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• Salomon, R., Hoffmann, E., Webster, R. G. (2007). Inhibition of the cytokine response does not protect against lethal H5N1 influenza infection. Proc. Natl. Acad. Sci. USA 104: 12479-12481 [Abstract] [Full Text]  
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• Shinya, K., Watanabe, S., Ito, T., Kasai, N., Kawaoka, Y. (2007). Adaptation of an H7N7 equine influenza A virus in mice. J. Gen. Virol. 88: 547-553 [Abstract] [Full Text]  
• Thomas, J. K., Noppenberger, J. (2007). Avian influenza: A review. Am J Health Syst Pharm 64: 149-165 [Abstract] [Full Text]  
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