Fatal clinical course of probable invasive pulmonary aspergillosis with influenza B infection in an immunocompetent patient

Abstract

Invasive pulmonary aspergillosis (IPA) is rarely reported in patients who have normal immune function. Recently, IPA risk was reported in nonimmunocompromised hosts, such as patients with chronic obstructive pulmonary disease and critically ill patients in intensive care units. Moreover, influenza infection is also believed to be associated with IPA among immunocompetent patients. However, most reports on IPA with influenza A infection, including pandemic influenza H1N1, and IPA associated with influenza B infection were scarcely reported. Here, we report probable IPA with a fatal clinical course in an immunocompetent patient with influenza B infection. We demonstrate IPA as a possible complication in immunocompetent patients with influenza B infection. Early clinical suspicion of IPA and timely antifungal therapy are required for better outcomes in such cases.

Keywords: Immunocompetence; Influenza B Virus; Invasive Pulmonary Aspergillosis.

Figure 1

(A) Normal chest radiograph on 3 days before admission. (B) Chest radiograph on admission showing bilateral pulmonary infiltrates and consolidations.

Figure 2

(A-C) A chest computed tomography scan on admission revealed multifocal patchy consolidation, ground-glass opacities, and centrilobular nodules in both lungs.

Figure 3

Gomori's methenamine silver stain of bronchoalveolar lavage fluid specimen revealing characteristic septate hyphae branching at less than 45° (×400).