‘Cytokine storm’ nearly claimed the life of a little girl with influenza A

The patient’s parents said the baby had not been vaccinated against seasonal flu, and started with common flu symptoms such as cough, fever, and runny nose. After only a short time, the baby became more tired and went to the local hospital in a state of heart failure, being monitored for fulminant myocarditis.

The baby was transferred to the Internal Medicine Intensive Treatment Department, National Children’s Hospital. The doctor diagnosed the child with influenza A/H3 with many serious complications: fulminant myocarditis, rhabdomyolysis, acute kidney injury and cytokine storm – an excessive systemic inflammatory response. The child does not respond to conventional medications and supportive treatments.

On December 23, Associate Professor Dr. Ta Anh Tuan, Head of the Internal Medicine Intensive Treatment Department, said that the baby’s organs were damaged due to two reasons. First, the flu virus causes direct damage. The second is cytokine storm, when the body’s inflammatory response is too strong, leading to silent but severe organ failure. Besides, flu infection also increases the risk of bacterial superinfection, making the condition more complicated and severe.

Due to unresponsiveness to medical treatments, the patient was prescribed multiple intensive resuscitation measures at the same time. The baby was supported with mechanical ventilation, ECMO intervention (cardiopulmonary bypass), continuous hemodialysis combined with hemodialysis adsorption, plasma exchange and IVIG (immune globulin), anti-influenza antiviral drugs and strong broad-spectrum antibiotics.

After 10 days of ECMO intervention and 18 days of continuous dialysis, the patient’s condition was gradually controlled. Currently, the child’s health is stable, organ functions are gradually recovering and continue to be monitored.

MSc. Tran Dang Rot, Department of Internal Medicine Intensive Treatment, said the baby was considered a rare and severe case of influenza A/H3 complications. According to medical literature, in the world there are only very few reported cases of influenza A with severe complications such as acute myocarditis, rhabdomyolysis and cytokine storm with the same severity as this patient.

Seasonal flu in general and influenza A in particular can cause many dangerous complications that threaten children’s lives if not detected and treated promptly.

The Ministry of Health recommends seasonal flu vaccination to help reduce serious complications. Therefore, parents need to proactively get their children from 6 months old vaccinated against flu every year. When children have unusual signs such as prolonged high fever, extreme fatigue, rapid breathing, muscle pain, little urination or changes in consciousness, they should be taken to a medical facility for timely examination and treatment.