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Sepsis and Pleural Empyema Caused by Streptococcus pyogenes after Influenza A Virus Infection

Fumihiro Ochi1, Hisamichi Tauchi1, Toshihiro Jogamoto1

  • 1Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Toon, Japan.

Case Reports in Pediatrics
|October 23, 2018
PubMed

Insights

Group A Streptococcus (GAS) can cause severe invasive infections in children. This case highlights GAS-induced pleural empyema following influenza A, suggesting viral-induced immune changes may increase bacterial superinfection risk.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Immunology

Background:

  • Streptococcus pyogenes (Group A Streptococcus, GAS) is a significant pathogen causing severe invasive diseases in children.
  • Pleural empyema is a rare but serious manifestation of GAS infection in pediatric populations.

Observation:

  • A 4-year-old boy developed GAS-induced pleural empyema after an influenza A virus infection.
  • Treatment involved antibiotics, chest-tube drainage, and video-assisted thoracoscopic surgery, leading to clinical improvement.

Findings:

  • Elevated levels of cytokines, particularly IL-1β and IL-10, were observed one week post-influenza A infection.
  • These cytokine levels decreased as the patient's symptoms resolved.
  • IL-10 is known to increase during influenza virus-bacteria superinfections.

Implications:

  • Influenza virus infection may alter host immune responses, increasing susceptibility to secondary bacterial infections like GAS in children.
  • Understanding these immunological mechanisms is crucial for managing and preventing severe pediatric infections.
  • This case underscores the importance of considering secondary bacterial infections in children with influenza and respiratory symptoms.

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