Complicated features in a young child with influenza B virus pneumonia and co-infection with Stenotrophomonas maltophilia

• Published in: Annals of tropical paediatrics 2011-05, Vol.31 (2), p.159-162
• Main Authors: Chen, S-H, Huang, I-A, Wu, C-T, Hsia, S-H, Hung, P-C, Chiu, C-H
• Format: Article
• Language: English
• Subjects: Alternating hemiplegia of childhood; Biological and medical sciences; Bronchi - pathology; Bronchoscopy; Child, Preschool; Encephalomyelitis - diagnosis; Encephalomyelitis - etiology; flunarizine; General aspects; Humans; Influenza B virus; Influenza B virus - isolation & purification; Influenza virus; Influenza, Human - complications; Influenza, Human - diagnosis; Influenza, Human - pathology; Influenza, Human - virology; Male; Mediastinal Emphysema - diagnosis; Mediastinal Emphysema - etiology; Medical sciences; Pneumology; Pneumonia, Bacterial - complications; Pneumonia, Bacterial - diagnosis; Pneumonia, Bacterial - microbiology; Pneumonia, Bacterial - pathology; Respiratory system : syndromes and miscellaneous diseases; Stenotrophomonas maltophilia; Stenotrophomonas maltophilia - isolation & purification; Subcutaneous Emphysema - diagnosis; Subcutaneous Emphysema - etiology; topiramate
• ISSN: 0272-4936; 1465-3281
• DOI: 10.1179/1465328111Y.0000000012

A 3·5-year-old child with influenza B virus pneumonia developed pneumomediastinum and subcutaneous emphysema on the 3rd day of illness. Bronchoscopy demonstrated obstruction of the left main bronchus by mucopurulent sputum. Culture of the broncho-alveolar lavage yielded Stenotrophomonas maltophilia. After the respiratory complications resolved (11 days), the patient developed neurological symptoms and was diagnosed as acute disseminated encephalomyelitis (ADEM). Stenotrophomonas maltophilia was probably a factor in the development of pneumomediastinum. To our knowledge, this is the first case report of influenza virus infection with Stenotrophomonas maltophilia co-infection associated with spontaneous pneumomediastinum.