| Summary: | A case of 19 years old Thai male patient with fever for 7 days. The presenting symptom is URI . He had the history of died chicken contaction for 2 weeks before fever, and then developed pneumonia . Initial investigation showed like Dengue hemorrhagic fever, and negative for Both rapid test for avian flu and PCR for H5N1. Clinical progressed to severe pneumonia and respiratory failure.Intubation had done and started oseltamivir. Nasopharyngeal aspiration for rapid test and PCR for avian flu had done again, rapid test for influenza A: negative, PCR for positive H5N1 The patient developed cardiac arrest and expired finaly. Keywords: Avian flu, H5N1
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