Clinical course of respiratory mixed infection caused by five pathogens - SARS-CoV-2, influenza A(H₁N₁)pdm09, Streptococcus pneumoniae, Mycoplasma pneumonia, Candida albicans in a young patient

Background. Influenza represents a serious socio-economic problem, despite the fact that in the last 3 years the reported incidence has occurred in the form of local outbreaks. This was due to the predominant diagnosis of a new coronavirus infection associated with SARS-CoV-2 and the paradigm for monoinfection in one patient. Nevertheless, real clinical practice and wide possibilities for laboratory diagnostics have shown the acceptability of several infectious agents in one person at the same time. Starting from the end of 2022, the incidence of influenza began to grow in the structure of infectious pathology. At the same time, cases of co-infection with influenza and the new coronavirus infection COVID-19 began to be recorded.

Objective. This clinical case demonstrates the course of a coronavirus infection complicated by pneumonia in combination with influenza and the addition of three infectious agents Streptococcus pneumoniae, Mycoplasma pneumonia, Candida albicans in a young patient without predictors of a severe course.

Conclusion. Our clinical observation shows the importance of a thorough examination of the patient for such respiratory viral infections as the new coronavirus infection COVID-19, influenza A(H1N1)pdm09, which often develops with lung damage. During the period of rising incidence at the height of the epidemiological season, the doctor’s alertness regarding the development of a bacterial process in the lungs in such patients should remain at a high level. The widespread spread of coronavirus infection COVID-19, the massive number of admissions to infectious diseases and therapeutic hospitals, the presence of a similar X-ray picture of the lungs should alert the doctor regarding the adequate and rational use of antimicrobial and antiviral drugs, excluding the possibility of drug immunosuppression and subsequent activation of one’s own flora that can cause bacterial infections and fungal infection of the patient’s body.

1. Pinky L., Dobrovolny H. M. SARS-CoV-2 coinfections: could influenza and the common cold be beneficial? Journal of Medical Virology. 2020; 11 (92): 2623-2630.

2. Ma L., Han X., Ma Yu. et al. Decreased influenza vaccination coverage among Chinese healthcare workers during the COVID-19 pandemic. Infectious Diseases of Poverty. 2022; 1 (11): 1-11.

3. Lippi G., Sanchis-Gomar F., Henry B. M. Coronavirus disease 2019 (COVID-19): the portrait of a perfect storm. Annals of Translational Medicine. 2020; 7 (8): 497-499.

4. Полуэктова В. Б., Бурдова Е. Ю., Филатова А. П. и др. Сочетанное течение COVID-19 и гриппа: клиническая картина, диагностика, лечение. Эпидемиология и инфекционные болезни. 2020; 3 (25): 132-138.

5. Готвянская Т. П., Мукашева Е. А., Ноздрачева А. В. и др. Заболеваемость и популяционный иммунитет к гриппу и ОРВИ в условиях пандемии COVID-19. Санитарный врач. 2023; 3: 153-163.

6. Шведова Т. Н., Коптева О. С., Кударь П. А. и др. Роль коинфекции вирусами гриппа при тяжелом течении COVID-19. Медицинский академический журнал. 2021; 3 (21): 159-164. .

7. Михайлов А. О. и др. Клинические проявления астенического синдрома после коронавирусной инфекции, вызванной SARS-CoV-2. Журнал инфектологии. 2023; 2 (15): 60-67. https://doi.org/10.22625/2072-6732-2023-15-2-60-67

8. Калюжин О. В. Острые респираторные вирусные инфекции. Современные вызовы. Противовирусный ответ. Иммунопрофилактика и иммунотерапия. М.: МИА, 2014.

9. Сурков А. Н. Проблема антибиотик-ассоциированной диареи в практике врача-педиатра. Практика педиатра. 2013; 5: 22-28.

10. Душаева Л. Ж. Роль и значение Л-форм бактерий в инфекционной патологии и иммунологии. Наука и современность. 2011; 13-1: 49-53.

11. Иванис В. А., Попов А. Ф. Анализ летальных исходов от COVID-19 в Приморском крае. Тихоокеанский медицинский журнал. 2023; 2: 54-59. https://doi.org/10.34215/1609-1175-2023-2-54-59