A 51 year old immunocompetent man was admitted to the intensive care unit with severe acute respiratory distress syndrome caused by influenza A infection. He initially responded well to treatment. His respiratory status subsequently deteriorated and he developed multi-organ failure which prompted suspicion of either a bacterial or fungal co-infection, a recognised complication of influenza infection. Bronchoscopy revealed multiple pseudomembranes in the trachea (Fig. 1 ) and right and left main bronchi. Samples from brushings and bronchoalveolar lavage were sent to the laboratory. Culture of these yielded both Aspergillus flavus and Aspergillus fumigatus (Fig. 2 ). Unfortunately despite appropriate treatment the patient progressed to refractory multi-organ failure and died.
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