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

Ki Ho Nam; Jong Sam Hong; Man Yong Hong; Jae Min Lim; Mi Hye Kim; Bock Hyun Jung; Eun Hee Song; Dae Sik Ryu

doi:10.3947/ic.2011.43.5.425

Journal List > Infect Chemother > v.43(5) > 1035114

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Nam, Hong, Hong, Lim, Kim, Jung, Song, and Ryu: A Case of Pseudomembranous Tracheobronchitis Complicated by Coinfection of 2009 Pandemic Influenza A/H1N1 and Staphylococcus aureus

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2011; 43(5): 425-428.

Published online: 31 October 2011

DOI: https://doi.org/10.3947/ic.2011.43.5.425

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

Ki Ho Nam¹, Jong Sam Hong¹, Man Yong Hong¹, Jae Min Lim¹, Mi Hye Kim¹, Bock Hyun Jung¹, Eun Hee Song¹, Dae Sik Ryu²

¹Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

²Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Correspondence to Bock Hyun Jung, M.D. Department of Internal Medicine, Asan Gangneung Hospital, College of Medicine, University of Ulsan 415, Bangdong-ri, Sacheon-myun, Gangneung 210-711, Korea. Tel: +82-33-610-3319, Fax: +82-33-641-8066, jbh@gnah.co.kr

Received 26 April 2011 Revised 3 July 2011 Accepted 7 September 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Influenza, S. aureus, Tracheobronchitis, Pneumonia, Bronchoscope

Figures and Tables

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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