Tracheitis following Influenza A infection

A 40-year-old healthy woman presented with a fever and cough. Four days prior, she was clinically diagnosed with influenza A and was administered oseltamivir. Chest computed tomography showed right lower lobe consolidation. Multiplex polymerase chain reaction (PCR) test detected influenza A virus in nasopharyngeal swabs. Despite sulbactam/ampicillin treatment, the patient showed no improvement. Bronchoscopy revealed mucosal swelling and white plaques in the upper trachea, without purulence. Gram staining and a pathological examination of the biopsy specimen revealed no bacterial bodies or neutrophil aggregation, indicating no clear evidence of secondary infection. As antibiotics were ineffective, the treatment was switched to corticosteroids, which led to full resolution of the consolidation and tracheal lesions. Influenza-associated tracheitis may indicate disease severity and should prompt further diagnostic evaluation, including bronchoscopy.