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Influenza Pneumonia in Lung Transplant Recipients*: Clinical Features and Association With Bronchiolitis Obliterans Syndrome

Stavros Garantziotis, MD; David N. Howell, MD, PhD; H. Page McAdams, MD; R. Duane Davis, MD, FCCP; Nancy G. Henshaw, PhD; Scott M. Palmer, MD, MHS
Author and Funding Information

*From the Departments of Medicine, Division of Pulmonary and Critical Care Medicine (Drs. Garantziotis and Palmer), Pathology (Drs. Howell and Henshaw), Radiology (Dr. McAdams), and Surgery (Dr. Davis), Duke University Medical Center, Durham, NC.

Correspondence to: Scott M. Palmer, MD, MHS, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Box 3876, Bell Building, Duke University Medical Center, Durham, NC 27710; e-mail: palme002@mc.duke.edu



Chest. 2001;119(4):1277-1280. doi:10.1378/chest.119.4.1277
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Influenza infection is increasingly recognized to cause significant morbidity and mortality in the community, especially in pediatric patients and elderly persons. Influenza infection, however, has not been well described among thoracic organ transplant recipients. We provide the first detailed clinical, radiographic, and histologic description of influenza pneumonia among three lung transplant recipients. The presentation varied considerably among the three patients and, in some cases, was atypical for influenza. Despite treatment, a persistent decline in pulmonary function occurred in all three patients after the acute illness. Interestingly, on follow-up biopsy specimens, each patient had histologic evidence of acute rejection and/or obliterative bronchiolitis. Additional research, therefore, is needed to clarify the relationship between influenza infection, acute rejection, and obliterative bronchiolitis.

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