| Summary: | Avian Influenza (AI) is an infectious disease caused by influenza virus which is transmitted by poultry. Influenza A (H5) is now become the leading epidemic avian flu in Hong Kong, China, Vietnam, Thailand, Indonesia, Korea, Japan, Laos and Cambodia. Recently the number of confirm case in Indonesia is increasing. Incubation period of AI is 2 to 17 days. Symptoms are fever, influenza-like illness; diarrhea, vomiting, abdominal pain, pleuritic pain, bleeding from nose and gums; encephalopathy; diarrhea without respiratory symptoms, dyspnea (range 1-16D) respiratory distress, tachypnea and inspiratory crackles. Sputum variable and sometimes bloody, pneumonia; diffuse multifocal or patchy infiltrates; interstitial infiltrates, segmental or lobular consolidation, progression to respiratory failure - diffuse, bilateral, ground-glass infiltrates and manifestations of ARDS median time 6 days. we can also find leukopenia (particularly lymphopenia), thrombocytopenia, elevated aminotransferases, marked hyperglycemia and elevated creatinine. Case Report: Male, 42 years old with chief complain of fever and abdominal pain and wrist pain since 3 days before hospitalized. The patient complaint of fever, sore throat, abdominal pain and wrist since 5 days before hospitalized. Three days before hospitalized, he had dyspnea and diarrhoea and worsening of symptoms then he came to hospital. There were positive of contact with poultry. From radiology there were bilateral and diffuse infiltrates. From laboratory findings we found leukopenia (particularly lymphopenia), thrombocytopenia and hyperglycemia. Rapid test antigen was positive of influenza A. The PCR was negative. There was not improvement seen during hospitalization. The patient declared died on the 5th day of admission. Postmortem biopsy revealed proliferation of macrophag and fibrine and the result of trans thoracal aspiration was positive of H3. Key words: avian influenza, respiratory distress, influenza-like illness https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1440-1843.2006.00997.x
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