Abstract
There have been many cases of infection caused by influenza A/H1N1pdm09. We encountered a case of hemophagocytosis with co-infections of influenza and group A streptococcus. A 24-year-old man was referred to us with multiple organ dysfunction syndrome due to influenza infection. When he was transferred to the previous hospital, he had high fever and disturbance of consciousness. On admission to our hospital, he showed respiratry and cardiac failure. His heart function was severely decreased, and we initiated mechanical ventilation, percutaneous cardiopulmonary support, and intra-aortic balloon pumping. Clinical findings of neutropenia, thrombocytopenia, and disseminated intravascular coagulation suggested a complication of hemophagocytosis; therefore, we tried immunosuppressive therapy and plasmapheresis. However, group A streptococcal bacteremia also occuered, and the patient expired in approximately 2 days. Necropsy showed histiocytes phagocytosing red blood cells and severe streptococcal invasion. Influenza is a very common disease. However, fatal complications may occur on rare occasions.
