Fatal case of swine influenza virus in an immunocompetent host

Swine influenza virus (SIV), a common zoonotic infection, affects swine, particularly during late autumn and winter. Transmission of SIV from pigs to humans has been reported occasionally; most cases are mild infections and rarely lead to death. Herein we describe an immunocompetent woman in whom the adult respiratory distress syndrome developed; she died of a fulminant course of swine influenza. The documented pathogen was the H1N1 strain of SIV. To our knowledge, only four other deaths in immunocompetent adults have been previously reported in the literature. Our patient had a hemophagocytic syndrome, which may have contributed to her death.