Post-influenza aspergillosis, do not underestimate influenza B

Abstract

Our objective is to highlight and focus on post-influenza aspergillosis, triggered by influenza B virus. This relatively new clinical entity is often associated with a fulminant course of respiratory decline and high mortality. A 51-year immunocompetent woman, without any medical history or risk factors for developing a complicated influenza infection, was admitted to the intensive care unit. During admission, she presented with an afebrile flu-like syndrome, myocarditis, rhabdomyolysis, multiple organ failure, and evolved to severe respiratory distress. The broncho-alveolar lavage contained influenza B RNA, and the culture revealed Aspergillus fumigatus. Despite maximal organ support, immunoglobulin, antiviral and antifungal therapy, the patient died. This case demonstrates that influenza B virus may be life threatening even to immunocompetent adults and may trigger an invasive Aspergillus superinfection.

Influenza A Virus as a Predisposing Factor for Cryptococcosis

“…In addition, co-infection with IAV is well-described for the fungus Aspergillus spp. (Kwon et al, 2013 ; Alshabani et al, 2015 ; Crum-Cianflone, 2016 ; Nulens et al, 2017 ); however there are few studies of co-infection with other important respiratory fungal pathogens, e.g., Cryptococcus spp. The consequences of the co-infection with IAV-cryptococci are poorly studied, being only available in two case reports describing the secondary cryptococcal meningitis during the 2009-pandemic influenza A H1N1 (Hosseinnezhad and Rapose, 2012 ; Gupta et al, 2015 ).…”

Acute fulminant invasive pulmonary aspergillosis in an immunocompetent host: An autopsy case report

“…Certain respiratory viral infections are said to involve risks for developing IPA [1] , [4] , [5] , [6] . Unfortunately, no data relevant to an influenza infection was available in the present case.…”

“…Several local and systemic risk factors are mutually involved, including malnourishment, chronic obstructive pulmonary disease (COPD), and alcoholism [1] , [2] , [3] , [4] . Certain viral respiratory infections, such as the influenza virus, may also predispose patients to this invasive fungal infection [1] , [4] , [5] , [6] .…”

Der Mensch und Influenza – ein Überblick

“…Post-Influenza-Aspergillose wird in den letzten Jahren bei intensivpflichtigen Patienten als relativ neue Entität entdeckt. Sie ist häufig mit einem respiratorischen Versagen und mit hoher Mortalität assoziiert [14].…”