Invasive fungal infections associated with prior respiratory viral infections in immunocompromised hosts

Saira Ajmal, Maryam Mahmood, Omar Abu Saleh, Jenifer Larson, M. Rizwan Sohail

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background: Increased risk of invasive pulmonary aspergillosis after influenza infection has been reported; however data are limited. Purpose: To describe Invasive fungal infections (IFI) associated with preceding respiratory viral infection at a large referral center. Methods: We reviewed all IFI cases among patients with positive influenza and/or RSV nasopharyngeal/lower respiratory tract PCR from October 2015 to December 2016. Cases of pulmonary IFI were classified as possible, probable, and definite based on EORTC-MSG definitions. Results: We identified 8 cases (4 influenza, 4 RSV); 3 with probable Aspergillosis, 1 possible Aspergillosis, 1 probable Histoplasmosis, 1 probable Mucormycosis, and 2 possible IFI (consistent clinical and imaging findings). Half of our patients were men with a mean age of 64 years (SD 8) and median Charlson Comorbidity Score of 3.5 (IQR 3-7). Most common risk factors were stem cell transplant (75%) and neutropenia (62.5%). Four patients were on antifungal prophylaxis at presentation. All patients received anti-viral therapy with oseltamivir/ribavirin and 50% received empiric antibiotics. Median duration from onset of viral infection to diagnosis of IFI was 8.5 days (IQR 2.5-14) and 75% were diagnosed during the same admission. All received antifungal therapy; 62.5% required ICU care, and 37.5% died during index hospitalization. Conclusions: Our study supports earlier observations describing IFI following respiratory viral infection in immunocompromised hosts. Secondary IFI occurred in 1.4% of our cohort and most occurred during the index admission. IFI following viral illness is associated with high mortality and early detection and therapy may improve outcomes.

Original languageEnglish (US)
Pages (from-to)555-558
Number of pages4
Issue number4
StatePublished - Aug 1 2018


  • Fungal infection
  • Immunocompromised host
  • Influenza
  • Pulmonary invasive fungal infection
  • RSV

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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