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- Title
Complicated Secondary Pneumonia after Swine-Origin Influenza A Virus Infection in an Immunocompetent Patient.
- Authors
Igusa, Ryotaro; Sakakibara, Tomohiro; Shibahara, Taizo; Sakamoto, Kazuhiro; Nishimura, Hidekazu; Ota, Kozo
- Abstract
The pandemic of the swine-origin influenza A virus (S-OIV) in 2009 demonstrated severe viral pneumonia followed by acute respiratory distress syndrome (ARDS). Although ARDS would be caused by the influenza virus pneumonia itself, it has remained unclear whether other respiratory viral or bacterial infections coexist with S-OIV pneumonia. We report an immunocompetent patient with methicillin-resistant Staphylococcus aureus (MRSA) and Herpes simplex virus (HSV) pneumonia secondary to S-OIV infection. A 57-year-old man previously without major medical illness was admitted to our hospital with severe pneumonia accompanied by ARDS due to S-OIV. In his clinical course, anti-influenza treatment was not effective. Sputum culture revealed the presence of MRSA, and HSV was isolated in broncho-alveoler lavage (BAL) fluid. Administration of an antiviral agent (acyclovir), an antibacterial agent (linezolid), and a corticosteroid (methylprednisolone) successfully improved the pneumonia and ARDS. HSV pneumonia can scarcely be seen in healthy people. However recently it has been recognized as a ventilator-associated pneumonia. Although coexistence of Streptococcus pneumoniae and MRSA was reported in S-OIV pneumonia, secondary viral infection has not been reported. The present report is the first patient with HSV pneumonia secondary to S-OIV infection. We propose that a possibility of hidden HSV pneumonia should be taken into consideration in patients with prolonged severe pneumonia due to influenza infection.
- Subjects
PNEUMONIA; INFLUENZA A virus; VIRUS diseases; IMMUNOCOMPETENT cells; RESPIRATORY distress syndrome; BACTERIAL diseases; METHICILLIN-resistant staphylococcus aureus; HERPES simplex virus
- Publication
Tohoku Journal of Experimental Medicine, 2012, Vol 226, Issue 2, p117
- ISSN
0040-8727
- Publication type
Article
- DOI
10.1620/tjem.226.117