Lethal Avian Influenza A (H5N1) Infection in a Pregnant Woman in Anhui Province, China

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Abstract
On November 2, 2005, fever, chills, and cough developed in a previously healthy woman who was four months pregnant. Chickens and ducks in her household had become ill and had died during October. From October 25 through October 30, the patient had been actively involved in slaughtering and defeathering sick poultry before they were cooked for family consumption. She presented to the hospital in Tongling City, China, on November 7 with dyspnea, cyanosis, a temperature of 38.8°C, a pulse of 118 beats per minute, a respiratory rate of 37 breaths per minute, and an oxygen saturation of 69 percent. Her white-cell count was 4050 per cubic millimeter, with a lymphocyte count of 608 per cubic millimeter. A chest radiograph showed bilateral diffuse infiltrates in the lower lobes. Her condition deteriorated despite treatment with azithromycin and cefotaxime. She required intubation that evening. The following day, her chest radiograph showed extensive infiltration of both lungs. Despite intensive supportive care, disseminated intravascular coagulation and multiorgan failure developed, and she died on November 10.

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