A Patient with Fulminant Influenza-Related Bacterial Pneumonia Due to Streptococcus pneumoniae Followed by Mycobacterium tuberculosis Infection

DOI IR HANDLE Web Site 2 Citations 16 References
  • Seki Masafumi
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Suyama Naofumi
    Nagasaki Municipal Medical Center
  • Hashiguchi Kohji
    The Japan Red Cross, Nagasaki Atomic Bomb Hospital
  • Hara Atsuko
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
  • Kosai Kosuke
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
  • Kurihara Shintaro
    The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Nakamura Shigeki
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
  • Yamamoto Kazuko
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Imamura Yoshifumi
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Izumikawa Koichi
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Kakaya Hiroshi
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Yanagihara Katsunori
    The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Yamamoto Yoshihiro
    The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Mukae Hiroshi
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
  • Tashiro Takayoshi
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences The Second Department of Internal Medicine, Nagasaki University School of Medicine
  • Kohno Shigeru
    Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences The Second Department of Internal Medicine, Nagasaki University School of Medicine

Search this article

Abstract

A 74-year-old man with poorly controlled diabetes mellitus was admitted to our hospital because of severe respiratory disturbance, fever, and sputum. We found massive consolidation of the right lung and nodular shadows on the left lung on chest X-ray, and detected influenza virus and Streptococcus pneumoniae antigen from a nasopharyngeal swab and urine sample, respectively. Co-infection with influenza virus and bacteria was suspected, and oseltamivir and biapenem were prescribed. Laboratory data improved after the addition of sivelestat sodium hydrate, an inhibitor of neutrophil-derived elastase; however, chest X-ray findings became worse on Day 8, and we administered 1 g methylprednisolone intravenously for two days. On Day 12, we detected Mycobacterium tuberculosis in the sputum, even though we did not previously detect any acid-fast bacilli, and started anti-tuberculosis drugs, such as isoniazid, rifampicin, ethambutol hydrochloride, and pyrazinamide; however, the patient died 12 days later. Severe influenza-related bacterial pneumonia with Streptococcus pneumoniae and subsequently secondary tuberculosis infection were finally suspected in this case. This was a very rare case in which additional tuberculosis infection was found in a patient with fulminant pneumonia due to co-infection of influenza virus and bacteria. It is necessary to observe patients with influenza carefully, especially when steroids are used, even if antibiotics are also administered.<br>

Journal

  • Internal Medicine

    Internal Medicine 47 (23), 2043-2047, 2008

    The Japanese Society of Internal Medicine

Citations (2)*help

See more

References(16)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top