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Acute Respiratory Failure in Idiopathic Pulmonary Fibrosis: Co-Infection With H1n1 And Cytomegalovirus: An Unexpected Common Denominator

Carmen Silvia Valente Barbas, Leonardo Lima Rocha, Gustavo Janot Faissol de Matos, Frederico Polito Lomar, Christina Shiang and Leticia Kawano-Dourado

We described a case of persistent influenza AH1N1 and cytomegalovirus respiratory infection in a patient with chronic interstitial lung disease and multiple bilateral pulmonary opacities. An open lung biopsy revealed diffuse organizing alveolar damage, necrotizing bronchiolitis, necrotizing pneumonia and alveolar hemorrhage, compatible with H1N1 infection as well as usual interstitial pneumonia. Diagnoses of an idiopathic CD4+ T cell lymphocytopenia and immunoglobulin G deficiency were made as an unexpected co-denominator of H1N1 and CMV persistent infection changing our treatment approach.