Community-acquired Pneumonia with Concurrent Multi-infections of Influenza A, Staphylococcus aureus, Streptococcus pneumoniae, Legionella and Invasive Pulmonary Aspergillosis in a Diabetic Patient

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Invasive pulmonary Aspergillus infection during or after severe influenza infection in an immunocompromised patient or a previously healthy person has been reported in the literature [1-2]. In addition, coinfections of Staphylococcus aureus or Streptococcus pneumoniae with influenza are common, whereas simultaneous infections of legionellosis with aspergillosis are unusual in patients with influenza [2]. We herein report a diabetic patient who presented with a community-acquired pneumonia (CAP). The initial sputum culture yielded Aspergillus species and S. aureus, which were coinfected with influenza A, Pneumococcus and Legionella, with a deteriorated fatal course.