Introduction

---

Oseltamavir is now being used on a large scale across the globe and this will contribute to the advancement of knowledge about side-effects and adverse events associated with use of oseltamivir. We would like to share our experience with regard to occurrence of epistaxis in two patients who were put on oseltamivir therapy for treatment of infection with novel strain of influenza (H1N1).

Case Report(s)

---

A 28 year old male presented with history of cough, nasal congestion and high grade fever for 2 days. He had developed dyspnoea for one day. He was febrile; had a respiratory rate of 32/min and his oxygen saturation on ambient air was 82%. He was otherwise hemodynamically stable. Auscultation of his chest revealed crackles in right infra-scapular region. Chest roentgenogram revealed infiltrates in right lower zone. Other investigations revealed a TLC of 12,000/mm3, Platelets-1.8 million/mm3, PT-13 seconds (control-12), and blood cultures were sterile. Swabs for H1N1 were returned positive by RT-PCR. He was put on oxygen inhalation, oseltamivir 75 mg BD, ceftriaxone. The patient improved with therapy. However on day four he developed epistaxis. The epistaxis was mild and no nasal packing was needed. We continued oseltamivir and patient was discharged after five days of therapy.
A 30 year old lady presented with history of fever, sore throat, running nose and cough for 4 days. She had no dyspnoea, tachypnea and maintained normal oxygen saturation on ambient air. Nasopharyngeal and oropharyngeal swabs for H1N1 were taken and the patient was put on Tab. Oseltamivir 75 mg BD for 5 days. The patient was advised home quarantine. The RT-PCR was positive for H1N1. On day three of the therapy, the patient informed that she had mild epistaxis which resolved on pinching the nose. We continued oseltamivir without recurrence of epistaxis.

Discussion

---

Epistaxis has been noted in paediatric trials in a similar percentage as in placebo group.^[1] The exact mechanism is not known. In these two adult patients, the epistaxis was self-abating and patients needed no active treatment.

Conclusion

---

Oseltamavir can cause epistaxis although the mechanism responsible is not clear.

Abbreviations(s)

---

TLC- Total leukocyte count

RT-PCR- Reverse transcriptase polymerase chain reaction.

Acknowledgement(s)

---

None

Authors contribution(s)

---

AS and RD drafted the manuscript while VS and PV reviewed it. All authors were involved in management of the patient.

References

---

1. Buck ML. Oseltamivir: A New Option for the Management of Influenza in Children. Medscape med students. [serial on the Internet]. 2001 Jan [ Cited 2010 Jan 6] Avalaible at  http://www.medscape.com/viewarticle/410918.

Source(s) of Funding

---

None

Competing Interests

---

None

Disclaimer

---

This article has been downloaded from WebmedCentral. With our unique author driven post publication peer review, contents posted on this web portal do not undergo any prepublication peer or editorial review. It is completely the responsibility of the authors to ensure not only scientific and ethical standards of the manuscript but also its grammatical accuracy. Authors must ensure that they obtain all the necessary permissions before submitting any information that requires obtaining a consent or approval from a third party. Authors should also ensure not to submit any information which they do not have the copyright of or of which they have transferred the copyrights to a third party.
Contents on WebmedCentral are purely for biomedical researchers and scientists. They are not meant to cater to the needs of an individual patient. The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. Your use of the WebmedCentral site and its contents is entirely at your own risk. We do not take any responsibility for any harm that you may suffer or inflict on a third person by following the contents of this website.