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Year : 2013  |  Volume : 30  |  Issue : 2  |  Page : 171  

Organizing pneumonia as a pulmonary sequela of swine flu

Departament of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Date of Web Publication11-Apr-2013

Correspondence Address:
Edson Marchiori
Departament of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-2113.110440

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How to cite this article:
Zanetti G, Hochhegger B, Marchiori E. Organizing pneumonia as a pulmonary sequela of swine flu. Lung India 2013;30:171

How to cite this URL:
Zanetti G, Hochhegger B, Marchiori E. Organizing pneumonia as a pulmonary sequela of swine flu. Lung India [serial online] 2013 [cited 2020 May 31];30:171. Available from: http://www.lungindia.com/text.asp?2013/30/2/171/110440

Comments on: Pulmonary sequelae in a patient recovered from swine flu


We read with great interest the case reported by Singh, et al., [1] who described pulmonary sequelae in a 29-year-old female patient who had recovered from swine flu (H1N1 influenza). The patient presented initially with ground-glass opacities detected by computed tomography (CT), and developed interstitial lung disease after recovery. The authors discussed the long-term consequences of swine flu, especially the development of pulmonary fibrosis. Subsequently, Joob, et al. [2] commented on the observations of Singh, et al. [1] and suggested that the long-lasting presentation in patients with swine flu could be due to the presence of concomitant underlying pulmonary disease or the possible role of swine flu infection in the deterioration of concomitant cardiovascular disease.

Recently, Lee, et al. [3] reviewed serial CT findings from patients with influenza A (H1N1) virus infection. They concluded that the lesions observed on initial CT scans tended to resolve to fibrosis, which then resolved completely or displayed substantially reduced residual disease. They also suggested that the pathophysiological mechanism underlying lung fibrotic changes caused by H1N1 might differ from those of other lung diseases and the patients with H1N1 and lung fibrotic changes were capable of self-rehabilitation. Histopathological studies have shown that these later changes are due to secondary organizing pneumonia (OP) in most cases. [4],[5],[6],[7],[8]

This issue is very important because pulmonary fibrosis observed in the recovery phase may, at least in part, account for the respiratory symptoms observed in these patients. The diagnosis of secondary OP after H1N1 infection is important because proper treatment of OP requires corticosteroid therapy. Physicians should be aware that OP may complicate the recovery of patients with H1N1 infection, and the development of late opacities observed on CT scans during recovery should suggest this diagnosis. [4],[7],[8]

   References Top

1.Singh V, Sharma BB, Patel V. Pulmonary sequelae in a patient recovered from swine flu. Lung India 2012;29:277-9.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Joob B, Wiwanitkit V. Pulmonary sequelae of swine flu. Lung India 2013;30:81-2.  Back to cited text no. 2
  Medknow Journal  
3.Li P, Zhang JF, Xia XD, Su DJ, Liu BL, Zhao DL, et al. Serial evaluation of high-resolution computed tomography findings in patients with pneumonia in novel swine-origin influenza A (H1N1) virus infection. Br J Radiol 2012;85:729-35.  Back to cited text no. 3
4.Gill JR, Sheng ZM, Ely SF, Guinee DG, Beasley MB, Suh J, et al. Pulmonary pathologic findings of fatal 2009 pandemic influenza A/H1N1 viral infections. Arch Pathol Lab Med 2010;134:235-43.  Back to cited text no. 4
5.Marchiori E, Zanetti G, Fontes CA, Santos ML, Valiante PM, Mano CM, et al. Influenza A (H1N1) virus-associated pneumonia: High-resolution computed tomography-pathologic correlation. Eur J Radiol 2011;80:e500-4.  Back to cited text no. 5
6.Gómez-Gómez A, Martínez-Martínez R, Gotway MB. Organizing pneumonia associated with swine-origin influenza A H1N1 2009 viral infection. AJR Am J Roentgenol 2011;196:W103-4.  Back to cited text no. 6
7.Marchiori E, Barreto MM, Hochhegger B, Zanetti G. Organising pneumonia as a late abnormality in influenza A (H1N1) virus infection. Br J Radiol 2012;85:841.  Back to cited text no. 7
8.Marchiori E, Zanetti G, Mano CM, Hochhegger B, Irion KL. Follow-up aspects of Influenza A (H1N1) virus-associated pneumonia: The role of high-resolution computed tomography in the evaluation of the recovery phase. Korean J Radiol 2010;11:587.  Back to cited text no. 8

This article has been cited by
1 Organizing pneumonia in swine flu
Joob B, Wiwanitkit V
Lung India. 2013; 30(4): 376-377
2 Authorsś reply
Zanetti G, Hochhegger B, Marchiori E
Lung India. 2013; 30(4): 377-378


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