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Influenza pneumonia — SCE Respiratory MCQ

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HardRespiratory InfectionsInfluenza pneumoniaSCE Respiratory

A 50-year-old man is admitted with influenza A pneumonia and rapidly increasing oxygen requirement. CXR shows bilateral infiltrates, lymphopenia and secondary bacterial infection is not yet proven. He is within 24 hours of admission but symptoms started 5 days ago. What is the most appropriate management?

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Correct answer: E — Start antiviral treatment and assess for bacterial coinfection

Hospitalised patients with suspected or confirmed influenza should receive antiviral therapy even when symptom onset was more than 48 hours earlier, alongside assessment for bacterial coinfection. The 48-hour rule mainly applies to otherwise healthy community presentations. Bronchodilators, TB therapy and elective bronchoscopy do not address severe influenza pneumonia.

Reference: UKHSA Influenza Treatment Guidance; NICE NG250