Severe pneumonia and acute respiratory distress syndrome caused by avian influenza A (H10N3) in a young female: a case report
- 1Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Zhuang Autonomous Region China
- 2Infection Business Unit, Tianjin Novogene Med LAB Co., Ltd., Tianjin, China
- 3Infection Business Unit, Novogene Co., Ltd., Beijing, China
Abstract
Background: Human infection with avian influenza A (H10N3) is a rare but severe emerging zoonotic disease. To date, only a limited number of cases have been reported, which restricts a comprehensive understanding of its clinical features and public health risks. We report the fourth documented case of human H10N3 infection, which is the first to be identified in a female patient. Additionally, we compared the clinical and genomic characteristics of all four cases.
Case presentation: A 23-year-old female with no prior comorbidities developed severe pneumonia and acute respiratory distress syndrome due to infection with avian influenza A (H10N3) virus. The patient, working in a fresh market with recent training at a slaughterhouse, presented a one-week history of high fever, cough, and dyspnea. Despite initial broad-spectrum antibiotics, her condition rapidly worsened, requiring mechanical ventilation and veno-venous extracorporeal membrane oxygenation (V-V ECMO). Metagenomic next-generation sequencing of bronchoalveolar lavage fluid, confirmed by the Centers for Disease Control and Prevention, identified avian influenza A (H10N3). Following approximately three months of intensive treatment, the patient recovered and was discharged. Phylogenetic analyses showed that her virus strain was closest to the third human H10N3 case (Kunming, China, 2024). In addition, this strain had a human-adapted substitution (P221) but lacked the G228S substitution in the haemagglutinin protein, suggesting that the latter is not essential for human infection.
Conclusions: This case highlights the potential for severe human infection by the H10N3 virus. It is imperative that surveillance is enhanced in both human and animal populations.
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BibTeX
@article{zhao2026severe,
title = {{Severe pneumonia and acute respiratory distress syndrome caused by avian influenza A (H10N3) in a young female: a case report}},
author = {Mei Zhao and Qiyun Shi and Lin Zhao and Meng Wang and Jingwen Li and Zhiyi Wan and Tun Ouyang and Yang Yu},
journal = {Infection},
year = {2026},
month = jul,
doi = {10.1007/s15010-026-02883-y},
url = {https://doi.org/10.1007/s15010-026-02883-y},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Severe pneumonia and acute respiratory distress syndrome caused by avian influenza A (H10N3) in a young female: a case report
AU - Mei Zhao
AU - Qiyun Shi
AU - Lin Zhao
AU - Meng Wang
AU - Jingwen Li
AU - Zhiyi Wan
AU - Tun Ouyang
AU - Yang Yu
PY - 2026
DA - 2026/07/17
JO - Infection
DO - 10.1007/s15010-026-02883-y
UR - https://doi.org/10.1007/s15010-026-02883-y
AB - Background: Human infection with avian influenza A (H10N3) is a rare but severe emerging zoonotic disease. To date, only a limited number of cases have been reported, which restricts a comprehensive understanding of its clinical features and public health risks. We report the fourth documented case of human H10N3 infection, which is the first to be identified in a female patient. Additionally, we compared the clinical and genomic characteristics of all four cases. Case presentation: A 23-year-old female with no prior comorbidities developed severe pneumonia and acute respiratory distress syndrome due to infection with avian influenza A (H10N3) virus. The patient, working in a fresh market with recent training at a slaughterhouse, presented a one-week history of high fever, cough, and dyspnea. Despite initial broad-spectrum antibiotics, her condition rapidly worsened, requiring mechanical ventilation and veno-venous extracorporeal membrane oxygenation (V-V ECMO). Metagenomic next-generation sequencing of bronchoalveolar lavage fluid, confirmed by the Centers for Disease Control and Prevention, identified avian influenza A (H10N3). Following approximately three months of intensive treatment, the patient recovered and was discharged. Phylogenetic analyses showed that her virus strain was closest to the third human H10N3 case (Kunming, China, 2024). In addition, this strain had a human-adapted substitution (P221) but lacked the G228S substitution in the haemagglutinin protein, suggesting that the latter is not essential for human infection. Conclusions: This case highlights the potential for severe human infection by the H10N3 virus. It is imperative that surveillance is enhanced in both human and animal populations.
SN - 0300-8126
SN - 1439-0973
ER -