Swine influenza virus (SIV), a common zoonotic infection, affects swin
e, particularly during late autumn and winter, Transmission of SIV fro
m pigs to humans has been reported occasionally; most cases are mild i
nfections and rarely lead to death, Herein we describe an immunocompet
ent woman in whom the adult respiratory distress syn drome developed;
she died of a fulminant course of swine influenza, The documented path
ogen was the H1N1 strain of SIV, To our knowledge, only four other dea
ths in immunocompetent adults have been previously reported in the lit
erature, Our patient had a hemophagocytic syndrome, which may have con
tributed to her death.