Influenza A Co-infection With Atypical Bacteria: A Report of Two Cases

Influenza A virus infection is associated with a wide range of clinical manifestations, from mild upper respiratory infections that resolve on their own to severe pneumonia and sepsis. Bacterial co-infections, particularly due to atypical pathogens such as <i>Chlamydia pneumoniae</i> and <i>Mycoplasma pneumoniae</i>, may alter disease severity and clinical presentation, especially in paediatric patients and adults with underlying comorbidities. We describe two cases of Influenza A virus infection complicated by atypical bacterial co-infections. The first case involved an elderly female with multiple chronic comorbidities who presented with respiratory sepsis and was found to have co-infection with Influenza A virus and <i>Chlamydia pneumoniae</i>. The second patient was a two-year-old female with concomitant infection due to Influenza A virus, <i>Chlamydia pneumoniae</i> and <i>Mycoplasma pneumoniae</i>. Pathogen identification was achieved using multiplex real-time polymerase chain reaction. In both patients, early initiation of targeted antiviral and antibacterial therapy resulted in clinical improvement and favourable outcomes. Co-infection with the influenza A virus and atypical bacterial pathogens can occur across age groups. Early microbiological diagnosis using multiplex molecular assays supports timely, pathogen-directed therapy and may mitigate disease severity and complications, thereby ensuring the good health and well-being of the patients.