This report describes the successful management of a documented necrotizing pneumonia due to Streptococcus pneumoniae in a child with pandemic influenza A (H1N1). The importance of early recognition of bacterial superinfection in patients with influenza and the immunologic interactive mechanisms between viruses and bacteria in determining respiratory diseases are highlighted. The role of modern molecular techniques in improving diagnostic microbiology sensitivity and informing consequent clinical care is emphasized.
HackettSHillLPatelJ. Clinical characteristics of paediatric H1N1 admissions in Birmingham, UK. Lancet2009; 374:605.
2.
LarcombePJMoloneySESchmidtPA. Pandemic (H1N1) 2009: A clinical spectrum in the general paediatric population. Arch Dis Child2011; 96:96–98.
3.
CalitriCGabianoCGarazzinoSPinonMZoppoMCuozzoMScolfaroCTovoPA. Clinical features of hospitalised children with 2009 H1N1 influenza virus infection. Eur J Pediatr2010; 169:2011–2015.
4.
O'RiordanSBartonMYauYReadSEAllenUTranD. Risk factors and outcomes among children admitted to hospital with pandemic H1N1 influenza. CMAJ2010; 182:39–44.
5.
Writing committee of the WHO consultation on clinical aspects of pandemic (H1N1) 2009 influenza. Clinical aspects of pandemic 2009 Influenza A (H1N1) virus infection. N Engl J Med2010; 362: 1708–1719.
6.
ObandoIValderrabanosESMillanJANethOW. Necrotising pneumonia due to influenza A (H1N1) and community-acquired methicillin-resistant Staphylococcus aureus clone USA300: Successful management of the first documented paediatric case. Arch Dis Child2010; 95:305–306.
7.
YazerJGiacomantonioMMacDonaldMLopushinskyS. Severe necrotizing pneumonia in a child with pandemic (H1N1) influenza. CMAJ2011; 183:215–219.
AzzariCMoriondoMIndolfiG. Realtime PCR is more sensitive than multiplex PCR for diagnosis and serotyping in children with culture negative pneumococcal invasive disease. PLoS One2010;5:e9282.
SawickiGSLuFLValimCClevelandRHColinAA. Necrotising pneumonia is an increasingly detected complication of pneumonia in children. Eur Respir J2008; 31:1285–91.
12.
MorensDMTaubenbergerJKFauciAS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: Implications for pandemic influenza preparedness. J Infect Dis2008; 198:962–70.
13.
LockmanJLFischerWAPerlTMValsamakisANicholsDG. The critically ill child with novel H1N1 influenza A: A case series. Pediatr Crit Care Med2010;11:173–178.
14.
CDC. Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1) - United States, May-August 2009. MMWR Morb Mortal Wkly Rep2009; 58:1071–74.
15.
AmpofoKHerbenerABlaschkeAJHeyrendCPoritzMKorgenskiK. Association of 2009 pandemic influenza A (H1N1) infection and increased hospitalization with parapneumonic empyema in children in Utah. Pediatr Infect Dis J2010; 29:905–9.
16.
SeeHBlondèRMarianiPTacquetMDumitrescuMAngoullvantF. Increased incidence of parapneumonic empyema in children at a French pediatric tertiary center during the 2009 influenza A (H1N1) virus pandemic. Pediatr Infect Dis2010; 129:786–87.
17.
PalaciosGHornigMCisternaD. Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza. PLoS One2009; 4:e8540.
18.
Perez-PadillaRde la Rosa-ZamboniDde LeonS Ponce. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med2009;361:680–89.
19.
The ANZIC Influenza Investigators. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med2009; 361:1925–34.
20.
Giamarellos-BourboulisEJRaftogiannisMAntonopouloA. Effect of novel influenza A (H1N1) virus in the human immune system. PLoS One2009; 4:e8393.
21.
MusherDM. Streptococcus pneumoniae. In: MandellGLBennettJEDolinR, editors. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 7th ed.Vol. 2. Philadelphia (PA): Churchill Livingstone Elsevier; 2010. Chap. 200.
22.
McCullersJA. Insights into the interaction between influenza virus and pneumococcus. Clin Microbiol Rev2006; 19:571–82.
23.
BrundageJF. Interactions between influenza and bacterial respiratory pathogens: Implications for bacterial preparedness. Lancet Infect Dis2006; 6: 303–12.
24.
RestiMMoriondoMCortimigliaM. Community-acquired bacteremic pneumococcal pneumonia in children: Diagnosis and serotyping by Realtime PCR on blood samples. Clin Infect Dis2010;51:1042–49.
25.
KlugmanKPChienYWMadhiSA. Pneumococcal pneumonia and influenza: A deadly combination. Vaccine2009; 27, (S)3:9–14.
26.
WrightPFKirklandKBModlinJF. When to consider the use of antibiotics in the treatment of 2009 H1N1 influenza-associated pneumonia. N Engl J Med2009; 361:112.