Influenza is a very serious infection that affects hundreds of thousands of people every year in the Czech Republic. The influenza disease was caused mainly due to the influenza virus A ( H1N1 ) in season 2012/2013 and most patients (88 %) had some of the risk factors. 29 year old man with a diagnosis of rheumatoid arthritis was admitted to the General Faculty Hospital Prague on 4th January 2013.
The respiratory insufficiency progressed and the artificial ventilation was required. CT scan showed bilateral ARDS.
Influenza A (H1N1) was confirmed and the treatment with antivirotics and antibiotics was started. After several days there was found Aspergillus fumigatus in a specimen from lower respiratory tract.
The pacient died on 3th February 2013 despite adequate antimicrobial therapy. Influenza pneumonia is often complicated by secondary bacterial infections, mostly pneumonia caused by Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae.
In immunosuppressed patients it is also necessary to think about superinfection with opportunistic pathogens.