Intensive Care Unit, Queen Elizabeth Hospital, Jordan, Hong Kong.
Hong Kong Med J. 2013 Dec;19(6):545-8. doi: 10.12809/hkmj133835.
Influenza and pneumococcus co-infection can cause severe morbidity and mortality. Usually, this entails influenza A, while infection by influenza B is rarely serious. The literature describes influenza A epidemics leading to prolific loss of lives, notably the 1918 epidemic was blamed for the deaths of 40 to 50 million people. In this report, four patients were infected by influenza B during the influenza epidemic of 2011/12 in Hong Kong. All of them were previously healthy and had no chronic diseases; they were admitted to the hospital due to influenza-like symptoms. They rapidly deteriorated with multi-organ failure, and were subsequently diagnosed to be infected with influenza B and streptococci that gave rise to severe pneumonia. Three of them were infected with Streptococcus pneumoniae and one with Streptococcus pyogenes. All of them had leukopenia, septic shock, and acute kidney injury; two of whom died despite aggressive antibiotic treatment and organ support in the intensive care unit. According to the literature, this is the second case report of severe invasive pneumococcal pneumonia secondary to influenza B infection.
流感和肺炎球菌合并感染可导致严重的发病率和死亡率。通常情况下，这涉及到甲型流感，而乙型流感感染很少严重。文献描述了甲型流感流行导致大量死亡，特别是 1918 年的流感大流行被归咎于造成 4000 万至 5000 万人死亡。在本报告中，香港 2011/12 年流感流行期间有 4 名患者感染了乙型流感。他们均既往健康，无慢性疾病；因流感样症状而入院。他们迅速恶化，出现多器官衰竭，随后被诊断为感染乙型流感和链球菌，导致严重肺炎。其中 3 人感染肺炎链球菌，1 人感染化脓性链球菌。他们均出现白细胞减少、感染性休克和急性肾损伤；其中 2 人尽管在重症监护病房接受了积极的抗生素治疗和器官支持，但仍死亡。根据文献，这是第二例由乙型流感感染引起的严重侵袭性肺炎球菌肺炎的病例报告。
