CONCURRENT H1N1 INFLUENZA AND STAPHYLOCOCCUS AUREUS INFECTIVE ENDOCARDITIS IN A PATIENT WITH MULTIPLE COMORBIDITIES: A CASE REPORT AND LITERATURE REVIEW

Infective endocarditis (IE) in the context of H1N1 influenza imposes clinical challenges in the diagnosis and management of both conditions. The symptoms on presentation of IE and H1N1 are similar and may include fever and malaise, which may cause the diagnosis of IE to be delayed, and thus at the time of diagnosis, the disease might be at an advanced stage (1). Co-infection enhances inflammation and has more severe cardiac and systemic manifestations, resulting in higher morbidity and mortality (2). Infection with H1N1 flu has been shown to be immunosuppressive making IE more severe. Also, the treatment of H1N1 with antiviral drugs could interact with antibiotics required to treat IE (3). Moreover, the presence of H1N1 respiratory infection could cause a delay in the required diagnostic procedures of IE. This further establishes the rationale of, increased clinical scrutiny, combined diagnostic methods, and a multidisciplinary team approach in order to provide the best care to patients with both these infections.