Influenza A (H1N1) virus infection complicated by checkpoint inhibitor pneumonitis: A case report.
- 1Department of Critical Care Medicine, Beijing Jishuitan Hospital, Capital Medical University, Beijing, People's Republic of China.
- 2Department of Critical Care Medicine, Peking University People's Hospital, Beijing, People's Republic of China.
Abstract
Rationale
Checkpoint inhibitor pneumonitis (CIP) is a common, potentially severe adverse event in cancer patients receiving neoadjuvant immunotherapy, with glucocorticoids as the standard first-line treatment. Traditionally, glucocorticoids are avoided in confirmed viral pneumonia because they may delay viral clearance and increase secondary infection risk. No standardized strategy is available for managing concurrent CIP and viral pneumonia, and inappropriate treatment can lead to irreversible clinical deterioration.Patient concerns
Following neoadjuvant immunotherapy, the patient developed concurrent influenza A (H1N1) infection and CIP, accompanied by persistent respiratory dysfunction and progressive pulmonary lesions.Diagnoses
Combined with the patient's immunotherapy history, respiratory symptoms, imaging changes, and positive influenza A (H1N1) etiological results, a final diagnosis of concurrent CIP and H1N1 viral pneumonia was established.Interventions
The patient initially received antiviral and empirical antibiotic therapy. Due to ongoing clinical deterioration and poor response to anti-infective treatment, glucocorticoids were reinitiated to target CIP after comprehensive evaluation.Outcomes
The patient showed early radiographic worsening and intractable respiratory failure with no response to initial anti-infective management. After glucocorticoid administration, clinical symptoms and pulmonary lesions improved significantly, achieving a favorable recovery.Lessons
Isolated antiviral and antibiotic treatment may fail to control disease progression in patients with concurrent CIP and influenza A pneumonia. Timely and rational glucocorticoid use can reverse clinical deterioration and improve prognosis even in the setting of active viral infection. This case provides practical evidence for the individualized management of overlapping CIP and viral pneumonia.
Related
- Clinical, Radiologic, and Highest-Grade Assessment of Immune Checkpoint Inhibitor Pneumonitis in Non–Small Cell Lung Cancer
- 1027 Foundation-model-based CT detection of pneumonitis-compatible abnormalities during immune checkpoint inhibitor surveillance
- Immune Checkpoint Inhibitor-Associated Pneumonitis in Patients Treated for Metastatic Renal Cell Carcinoma.
- Corticosteroid-refractory checkpoint inhibitor pneumonitis in lung cancer: biological heterogeneity and mechanism-informed management
- Case Report: Serplulimab-induced checkpoint inhibitor pneumonitis in extensive-stage small cell lung cancer with underlying COPD: a case report and literature review.
BibTeX
@article{cheng2026influenza,
title = {{Influenza A (H1N1) virus infection complicated by checkpoint inhibitor pneumonitis: A case report.}},
author = {Yifan Cheng and Huiying Zhao and Youzhong An},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051109},
url = {https://europepmc.org/article/MED/42888550},
note = {CC BY},
}
RIS
TY - JOUR
TI - Influenza A (H1N1) virus infection complicated by checkpoint inhibitor pneumonitis: A case report.
AU - Yifan Cheng
AU - Huiying Zhao
AU - Youzhong An
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051109
UR - https://europepmc.org/article/MED/42888550
AB - Rationale Checkpoint inhibitor pneumonitis (CIP) is a common, potentially severe adverse event in cancer patients receiving neoadjuvant immunotherapy, with glucocorticoids as the standard first-line treatment. Traditionally, glucocorticoids are avoided in confirmed viral pneumonia because they may delay viral clearance and increase secondary infection risk. No standardized strategy is available for managing concurrent CIP and viral pneumonia, and inappropriate treatment can lead to irreversible clinical deterioration.Patient concerns Following neoadjuvant immunotherapy, the patient developed concurrent influenza A (H1N1) infection and CIP, accompanied by persistent respiratory dysfunction and progressive pulmonary lesions.Diagnoses Combined with the patient's immunotherapy history, respiratory symptoms, imaging changes, and positive influenza A (H1N1) etiological results, a final diagnosis of concurrent CIP and H1N1 viral pneumonia was established.Interventions The patient initially received antiviral and empirical antibiotic therapy. Due to ongoing clinical deterioration and poor response to anti-infective treatment, glucocorticoids were reinitiated to target CIP after comprehensive evaluation.Outcomes The patient showed early radiographic worsening and intractable respiratory failure with no response to initial anti-infective management. After glucocorticoid administration, clinical symptoms and pulmonary lesions improved significantly, achieving a favorable recovery.Lessons Isolated antiviral and antibiotic treatment may fail to control disease progression in patients with concurrent CIP and influenza A pneumonia. Timely and rational glucocorticoid use can reverse clinical deterioration and improve prognosis even in the setting of active viral infection. This case provides practical evidence for the individualized management of overlapping CIP and viral pneumonia.
SN - 0304-5412
SN - 1536-5964
ER -