Influenza pneumonia in lung transplant recipients - Clinical features and association with bronchiolitis obliterans syndrome

Influenza infection is increasingly recognized to cause significant morbidi ty and mortality in the community, especially in pediatric patients and eld erly persons. Influenza infection, however, has not been well described amo ng thoracic organ transplant recipients. We provide the first detailed clin ical, radiographic, and histologic description of influenza pneumonia among three lung transplant recipients. The presentation varied considerably amo ng the three patients and, in some cases, was atypical for influenza. Despi te treatment, a persistent decline in pulmonary function occurred in all th ree patients after the acute illness. Interestingly, on follow-up biopsy sp ecimens, each patient had histologic evidence of acute rejection and/or obl iterative bronchiolitis. Additional research, therefore, is needed to clari fy the relationship between influenza infection, acute rejection, and oblit erative bronchiolitis.