Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women
| Autor: | Evelyne Bucher, Maja Weisser, Timothy Aebi, Hans H. Hirsch, Stephan Marsch, Martin Siegemund |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
medicine.medical_specialty Streptococcus pyogenes Secondary infection Population Case Report medicine.disease_cause lcsh:Infectious and parasitic diseases Medical microbiology Internal medicine Streptococcal Infections Streptococcus pneumoniae Pandemic Influenza Human medicine Humans lcsh:RC109-216 education education.field_of_study business.industry Septic shock Bacterial pneumonia virus diseases Pneumonia Middle Aged medicine.disease Respiration Artificial Shock Septic Influenza B virus Infectious Diseases Immunology Female business |
| Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, Vol 10, Iss 1, p 308 (2010) |
| ISSN: | 1471-2334 |
| Popis: | Background Since the Influenza A pandemic in 1819, the association between the influenza virus and Streptococcus pneumoniae has been well described in literature. While a leading role has been so far attributed solely to Influenza A as the primary infective pathogen, Influenza B is generally considered to be less pathogenic with little impact on morbidity and mortality of otherwise healthy adults. This report documents the severe synergistic pathogenesis of Influenza B infection and bacterial pneumonia in previously healthy persons not belonging to a special risk population and outlines therapeutic options in this clinical setting. Case Presentation During the seasonal influenza epidemic 2007/2008, three previously healthy women presented to our hospital with influenza-like symptoms and rapid clinical deterioration. Subsequent septic shock due to severe bilateral pneumonia necessitated intensive resuscitative measures including the use of an interventional lung assist device. Microbiological analysis identified severe dual infections of Influenza B with Streptococcus pyogenes in two cases and Streptococcus pneumoniae in one case. The patients presented with no evidence of underlying disease or other known risk factors for dual infection such as age (< one year, > 65 years), pregnancy or comorbidity. Conclusions Influenza B infection can pose a risk for severe secondary infection in previously healthy persons. As patients admitted to hospital due to severe pneumonia are rarely tested for Influenza B, the incidence of admission due to this virus might be greatly underestimated, therefore, a more aggressive search for influenza virus and empirical treatment might be warranted. While the use of an interventional lung assist device offers a potential treatment strategy for refractory respiratory acidosis in addition to protective lung ventilation, the combined empiric use of a neuraminidase-inhibitor and antibiotics in septic patients with pulmonary manifestations during an epidemic season should be considered. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink