A case of community-acquired pneumonia due to influenza A virus and Nocardia farcinica co-infection |
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| Institution: | 1. Department of Respiratory Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan;2. Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan;1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;2. Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan;3. Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan;4. Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;5. Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan;6. School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan;7. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan;8. China Medical University, Taichung, Taiwan;1. Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital, Japan;2. Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Japan;3. Department of Clinical Laboratory, Tokyo Metropolitan Komagome Hospital, Japan;1. Servicio de Anestesiología y Reanimación, Hospital Universitario Infanta Leonor, Madrid, España;2. Department of Anesthesia, Blekinge County Council Hospital, Karlskrona, Suecia |
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| Abstract: | Nocardia spp. has not been reported previously as a cause of post-influenza pneumonia. Here we present a first case of post-influenza bacterial pneumonia due to Nocardia farcinica. Initial reason for hospitalization of the 90 year old female patient was a pneumonia with the symptoms of fever and productive cough. A rapid test for influenza antigen was positive for influenza A virus. Treatment with Zanamivir and piperacillin was initiated. However, after 1 week of treatment, the infiltration shadows on chest X-ray had worsened. Because the expectorated sputum collected on admission for culture was found to be positive for Nocardia spp., piperacillin was replaced with trimethoprim/sulfamethoxazole, and a chest X-ray showed some improvement.Although pulmonary nocardiosis with co-infection with influenza A is extremely rare, clinicians should be alert to the possibility. |
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| Keywords: | Influenza Post-influenza bacterial pneumonia Co-infection |
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