Fatal Aspergillosis Following Influenza Infection

luke-curtis
(Nulens, Bourgeois et al. 2017)
Life threatening fungal infections such as Aspergillus and Candida frequently occur after or concurrently with bacterial and viral infections of lungs or other organs. Multiple infections can weaken the immune system, cause inflammation and sepsis, and cause malnutrition.  

A case report was presented of a previously healthy 51 year old woman who developed influenza. After 3 days she was admitted to the hospital which suspected myocarditis and rhabdomyolysis.

Amoxicillin antibiotic was started at once. An echogram of the heart show some dysfunction with a left ejection fraction of 40%. She soon developed multiple organ failures and acute respiratory distress syndrome (ARDS) and was intubated. Testing for many types of bacteria or viruses such as cytomegalovirus, Epstein Barr virus, Cocksackie virus, hepatitis C virus, or parvo B19 virus were all negative.

 

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However, biopsies in several areas of the lung revealed massive growth of Aspergillus fumigatus fungi. At 14 days after admission she was treated with the antifungal drug voriconazole. Her condition continued to worsen and she died on day 22. 

The presence of bacterial superinfections following influenza is well described- however the presence of fungal superinfections after influenza may be greatly underreported. Medical personnel should be aware of possible fungal infections after influenza infection and treat accordingly.
 

References / Sources

Nulens, E. F., et al. (2017). “Post-influenza aspergillosis, do not underestimate influenza B.” Infect Drug Resist 10: 61-67. .

 

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