Infect Chemother.  2011 Oct;43(5):425-428. 10.3947/ic.2011.43.5.425.

A Case of Pseudomembranous Tracheobronchitis Complicated by Coinfection of 2009 Pandemic Influenza A/H1N1 and Staphylococcus aureus

Affiliations
  • 1Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea. jbh@gnah.co.kr
  • 2Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Abstract

An influenza pandemic due to a novel influenza A/H1N1 virus occurred after April 2009. This virus has some characteristics that differentiate it from the seasonal influenza virus. The 2009 pandemic influenza A/H1N1 virus can frequently infect the lower respiratory tract, and it might cause acute tracheobronchitis as well as pneumonia. Viral-bacterial interaction is well known as an important mechanism of the pathogenesis of respiratory complications of influenza. Herein, we report on a case that presented with pseudomembranous tracheobronchitis complicated by coinfection with 2009 pandemic influenza A/H1N1 and Staphylococcus aureus. We also review the relevent literature.

Keyword

Influenza; S. aureus; Tracheobronchitis; Pneumonia; Bronchoscope

MeSH Terms

Bronchoscopes
Coinfection
Influenza, Human
Orthomyxoviridae
Pandemics
Pneumonia
Respiratory System
Seasons
Staphylococcus
Staphylococcus aureus
Viruses

Figure

  • Figure 1 (A) The initial chest X-ray showed multiple nodular opacities in both lung fields. (B) The chest X-ray taken 6 days after admission showed progressed consolidation and patchy infiltration in both lung fields. (C) The follow-up chest X-ray after discharge showed that the multifocal pneumonic infiltrations had cleared up.

  • Figure 2 The initial chest CT showed multiple centrilobular opacities in both lungs, and diffuse bronchial thickening and narrowing of both bronchi.

  • Figure 3 (A), (B) The initial bronchoscopic findings showed severe mucosal inflammation and focal ulcerations with a pseudomembrane at the posterior membranous wall of the tracheobronchial tree. (C) A follow-up bronchoscopy 6 days later showed the much-improved mucosal inflammation and the disappearance of the pseudomembrane in the tracheobronchus.


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