Triple Co-Infection with Influenza A, Severe Acute Respiratory Syndrome Coronavirus 2, and Streptococcus pneumoniae: A Case Report

Abstract

Background: Viral respiratory infections can predispose patients to secondary bacterial pneumonia. It is rare for an
infection to occur concurrently with Influenza and SARS-CoV-2; adding Streptococcus pneumoniae is a rare but serious
clinical entity that is associated with significant morbidity and mortality.
Case Presentation: A 58-year-old male patient, without significant comorbidities, presented with high-grade fever,
productive cough, dyspnea, and altered sensorium in emergency department of Jinnah hospital, Lahore. RT-PCR
performed on nasopharyngeal swabs showed positivity for Influenza A and SARS-CoV-2. Blood culture revealed the
growth of Streptococcus pneumoniae. Chest imaging showed features of bilateral multilobar pneumonia. He received
a therapeutic course of antivirals, broad-spectrum antibiotics, corticosteroids, and supportive care, culminating in
clinical improvement.
Conclusion: This case highlights the consideration of bacterial co-infection in patients with dual viral respiratory
infections and the need for early microbiological testing and appropriate, timely antimicrobial therapy. COVID-19,
Influenza, Streptococcus pneumoniae, co-infection,