Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women

<p>Abstract</p> <p>Background</p> <p>Since the Influenza A pandemic in 1819, the association between the influenza virus and <it>Streptococcus pneumoniae </it>has been well described in literature. While a leading role has been so far attributed solely to In...

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Main Authors: Hirsch Hans H, Bucher Evelyne, Weisser Maja, Aebi Timothy, Marsch Stephan, Siegemund Martin
Format: Article
Language:English
Published: BMC 2010-10-01
Series:BMC Infectious Diseases
Online Access:http://www.biomedcentral.com/1471-2334/10/308
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spelling doaj-b1c0d3a40aef48d4869f9f6803116c5d2020-11-25T03:42:29ZengBMCBMC Infectious Diseases1471-23342010-10-0110130810.1186/1471-2334-10-308Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy womenHirsch Hans HBucher EvelyneWeisser MajaAebi TimothyMarsch StephanSiegemund Martin<p>Abstract</p> <p>Background</p> <p>Since the Influenza A pandemic in 1819, the association between the influenza virus and <it>Streptococcus pneumoniae </it>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.</p> <p>Case Presentation</p> <p>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 <it>Streptococcus pyogenes </it>in two cases and <it>Streptococcus pneumoniae </it>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.</p> <p>Conclusions</p> <p>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.</p> http://www.biomedcentral.com/1471-2334/10/308
collection DOAJ
language English
format Article
sources DOAJ
author Hirsch Hans H
Bucher Evelyne
Weisser Maja
Aebi Timothy
Marsch Stephan
Siegemund Martin
spellingShingle Hirsch Hans H
Bucher Evelyne
Weisser Maja
Aebi Timothy
Marsch Stephan
Siegemund Martin
Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women
BMC Infectious Diseases
author_facet Hirsch Hans H
Bucher Evelyne
Weisser Maja
Aebi Timothy
Marsch Stephan
Siegemund Martin
author_sort Hirsch Hans H
title Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women
title_short Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women
title_full Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women
title_fullStr Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women
title_full_unstemmed Co-infection of Influenza B and Streptococci causing severe pneumonia and septic shock in healthy women
title_sort co-infection of influenza b and streptococci causing severe pneumonia and septic shock in healthy women
publisher BMC
series BMC Infectious Diseases
issn 1471-2334
publishDate 2010-10-01
description <p>Abstract</p> <p>Background</p> <p>Since the Influenza A pandemic in 1819, the association between the influenza virus and <it>Streptococcus pneumoniae </it>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.</p> <p>Case Presentation</p> <p>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 <it>Streptococcus pyogenes </it>in two cases and <it>Streptococcus pneumoniae </it>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.</p> <p>Conclusions</p> <p>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.</p>
url http://www.biomedcentral.com/1471-2334/10/308
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