Post-influenza aspergillosis, do not underestimate influenza B

Post-influenza aspergillosis, do not underestimate influenza B Eric FL Nulens,1 Marc JC Bourgeois,2 Marijke BML Reynders1 1Laboratory Medicine, Medical Microbiology, 2Department of Intensive Care, Algemeen Ziekenhuis Sint-Jan Brugge-Oostende AV, Brugge, Belgium Abstract: Our objective is to highlight and focus on post-influenza aspergillosis, triggered by influenza B virus. This relatively new clinical entity is often associated with a fulminant course of respiratory decline and high mortality. A 51-year immunocompetent woman, without any medical history or risk factors for developing a complicated influenza infection, was admitted to the intensive care unit. During admission, she presented with an afebrile flu-like syndrome, myocarditis, rhabdomyolysis, multiple organ failure, and evolved to severe respiratory distress. The broncho-alveolar lavage contained influenza B RNA, and the culture revealed Aspergillus fumigatus. Despite maximal organ support, immunoglobulin, antiviral and antifungal therapy, the patient died. This case demonstrates that influenza B virus may be life threatening even to immunocompetent adults and may trigger an invasive Aspergillus superinfection. Keywords: post-influenza aspergillosis, influenza B, invasive pulmonary aspergillosis, rhabdomyolysis, ARDS, antiviral therapy