Cardiac Involvement, Muscle Injury, & Encephalitis with Swine Flu

[indigo girl]

http://www3.signonsandiego.com/stories/2009/oct/16/childs-death-flu-mystery/

We have seen muscle injury, heart attacks as well as encephalitis with influenza before, but it is not

common. This child was also diagnosed with a UTI initially.

Influenza is not just a respiratory disease. Of course, swine flu also frequently involves the GI tract, hence

all the N/V mostly seen in kids.

They know the H1N1 virus had infiltrated the girl's cardiac muscles because enzymes that normally reside inside heart cells were flowing through her blood, a sure sign of significant tissue damage, Bradley said.

While it's common for influenza to infect muscles-that's why the flu often causes body aches-the virus rarely spreads to the heart. When it does, the result can be swift and deadly.

The infection can interfere with the heart's specialized cells, which conduct electricity and orchestrate the organ's pumping action, Bradley said. "If you don't have a coordinated contraction, blood doesn't pump out," he said.

Another possibility is encephalitis, or brain swelling caused by infection. The headaches that tormented Alitza could be a signal of this condition.

(hat tip pfi/pixie)

[indigo girl]

This is a case that occurred in 2007. I don't remember reading any follow up on it, and the link to the media is gone, but the info was archived at PFI, one of the flu forums.

http://www.singtomeohmuse.com/viewtopic.php?p=17606#17606

...when she collapsed, Olson was recovering from the flu.

"You got a perfectly healthy kid that's 24 years old and perfectly healthy. She gets the flu. All of a sudden she had seizures. And two weeks later she has a heart attack and dying? You know, that's just unbelievable," Phair said.

Not knowing adds to the already overwhelming grief.

"I think definitely we need some answers. if it had anything to do with the flu," Wilson said.

The medical examiner will determine the exact cause of Olson's death.

[indigo girl]

Two more cases from 2007, archived at Curevent flu forum:

http://www.curevents.com/vb/showpost.php?p=681329&postcount=14

Marija E. Alumbaugh died at a Seattle hospital Wednesday from myocarditis due to Influenza A , according to the King County Medical Examinier's office.That makes her the second child in the area to fall victim to influenza the past two weeks.

Last week, a 7-year-old girl from Kent died from heart tissue inflammation, complications from the flu.

[indigo girl]

Rhabdomyolysis is the rapid breakdown (lysis) of skeletal muscle. This is sometimes seen with influenza.

http://www.medscape.com/viewarticle/410705_3

The exact pathophysiology underlying influenza A-induced rhabdomyolysis is unknown. Two possible mechanisms have been postulated: direct viral invasion of the muscle fibers and toxin generation.[37] The histologic results of skeletal muscle biopsies have documented necrosis of the myofibrils, fiber degeneration with phagocytosis, fiber regeneration, and varying degrees of inflammatory reaction.[21-24,36] Tissue cultures of muscle biopsy specimens have grown influenza A.[36,38] This evidence suggests that direct invasion may have a causative role in precipitating rhabdomyolysis. However, electron microscopic examination of muscle specimens from patients with influenza A infection have failed to show this virus. To date, no putative toxins have been identified in cases of virus-induced rhabdomyolysis.[37]

Given the large number of individuals with influenza A infection, rhabdomyolysis associated with the virus maybe underreported. It appears from the reported cases that rhabdomyolysis associated with influenza A pneumonia occurs in a slightly older population than generalized influenza A infection. While equal numbers of male and female patients appear to have generalized influenza A-associated rhabdomyolysis, the combination of rhabdomyolysis and pneumonia due to this virus may arise more frequently in male patients. Renal dysfunction due to rhabdomyolysis occurs with the same frequency whether the patient has clinical evidence of pulmonary infection with influenza A or not. Although the number of cases is small, influenza A pneumonia does not appear to the worsen the mortality of patients with rhabdomyolysis related to this infection. Further study of this infectious process is warranted to confirm these observations.

Although influenza A accounts for a significant number of community-acquired pneumonias, rhabdomyolysis has rarely been reported in association with this virus. When rhabdomyolysis occurs in the setting of influenza A pneumonia, it does not appear to carry the same prognostic significance of bacterial pneumonia associated rhabdomyolysis. However, rhabdomyolysis in the setting of influenza infection A is important to identify. Early recognition of rhabdomyolysis allows for prompt institution of appropriate therapy and may minimize renal complications associated with this disorder.