After one hour she was admitted to the ICU and due to worsening hypoxemia (PaO2 48 mm Hg, while breathing 50% inspired oxygen), neurological impairment with a GCS of 10 (E = 2 V = 3 M = 5) and hemodynamic instability (blood pressure 80/40 mmHg, heart rate 46 beats per minute), she was intubated and mechanically ventilated. RT-PCR on a broncoalveolar lavage specimen was positive for H1N1 influenza infection.