Clinical features and management of a critical human case of H10N3 avian influenza: A case report and literature review

OBJECTIVES: Since the first human case of H10N3 Avian Influenza in Jiangsu, China (April 2021), three cases have been reported globally. However, clinical and treatment data remain limited. DESIGN OR METHODS: Therefore, we describe the fourth patient's epidemiology, clinical manifestations, diagnostics, treatment. RESULTS: A 23-year-old woman, previously well, presented on 12 Dec 2024 with fever, dry cough and breathlessness after pig and chicken contact. CT showed bilateral pneumonia. Despite high-flow oxygen and broad-spectrum antibiotics she deteriorated, requiring intubation, lung-protective ventilation and VV-ECMO. Bronchoalveolar lavage isolated H10N3 influenza virus. Treatment with oseltamivir and baloxavir plus prone-position ventilation led to clinical improvement. CONCLUSION: Due to its nonspecific early symptoms, H10N3 is difficult to diagnose promptly, increasing the risk. Early recognition, antiviral therapy, and aggressive support are essential in managing severe infections.