Hemoptysis in children with pandemic influenza H1N1 2009 infection.

Three patients were admitted to Hat Yai Hospital, Songkhla Thailand with hemoptysis. They were previously healthy children aged 6, 13, and 14 years old who had attended schools in which outbreaks of influenza had occurred. They all had a history of fever, rhinorrhea, and severe cough accompanied by hemoptysis. Two developed hemoptysis on Day 3 and the third on Day 6 of illness, with one of them displaying massive hemoptysis. Chest radiographs were compatible with viral pneumonia in two cases and the third case was unremarkable. Coagulation profiles in the severe case were carried out and were normal. All the patients responded very well to treatment with oseltamivir and did not require intubation. Their subsequent nasopharyngeal swabs were positive for human pandemic influenza A H1N1 by real-time reverse transcription-polymerase chain reaction (RT-PCR), and their sputum for acid-fast bacilli and tuberculin skin tests were negative.