Cough with fever and chil...

The patient was a 68-year-old woman with a previous history of hypertension and cholecystectomy. One week before admission, the patient had been exposed to live poultry, which might have resulted in a dry cough accompanied by fatigue, chills, and fever that gradually progressed to shortness of breath and dyspnea. Chest radiography suggested pneumonia of the bilateral lower lungs. The alveolar lavage fluid was assessed by fluorescent polymerase chain reaction, which detected 1.84 × 106 copies/mL of the H7N9 virus RNA, and the nucleic acid of Epstein-Barr virus (EBV) was positive.

Examination

Examinations were carried out at the time of admission. Blood routine showed white blood cell count being 19.76 × 109/L and neutrophil percentage 90.2%. The procalcitonin was 0.29 ng/m. The chest radiography showed patchy, roundish, and sheet-like blurred shadow in bilateral lungs (Fig. ​(Fig.1A).1A). The anticardiolipin antibodies, the anti-nuclear autoantibodies (ANA), the neutrophil cytoplasmic autoantibodies, blood culture, sputum culture, alveolar lavage fluid culture, and mid-stream urine culture were negative.