A Patient with Fulminant Primary Influenza Pneumonia Which Developed into Secondary Bacterial Pneumonia

Abstract

An 88-year old man was admitted to our hospital because of severe respiratory disturbance and fever, but no sputum. We found diffuse reticular shadow on chest X-ray, and detected influenza virus antigen from nasopharyngeal swab. Primary influenza pneumonia was suspected and oseltamivir was prescribed. Data were improved after adding steroid; however, hemoptysis appeared on day 9, and the patient died 2 days later. We suspected the recurrence of primary virus pneumonia with alveolar damage, but Staphylococcus aureus was cultured from the hemosputum after his death despite oral administration of antibiotics. Subsequent secondary bacterial pneumonia as well as severe primary influenza virus pneumonia was finally suspected in this case. It was a rare case that not only fulminant primary virus pneumonia but also different type of severe influenza pneumonia were found in one patient. We need to observe influenza patients carefully, even if antibiotics were administered.