A renal lesion in association with influenza.

Between the beginning of October, 1957, and the end of January, 1958, seven cases of influenza came to necropsy at the Royal Free Hospital. All these patients had influenzal tracheitis, bronchitis, and bronchopneumonia, and six of them ,died from this cause. Influenza virus A (Asian strain) was isolated from the lungs of all six. In two cases the virus was the only pathogen, but in the other four there was also a secondary bacterial invader; three patients' lungs yielded Staph. pyogenes and the other Klebsiella pneumoniae. From the lungs of the seventh patient no virus was grown, but this young woman died during a relapse of the influenza. She had suppurative pericarditis and suppurative bronchopneumonia with lung abscess in addition to the influenzal lesions of the respiratory tract; from all the suppurative lesions Strep. pyogenes was isolated. The clinical features, urinary findings, treatment, and post-mortem appearances are summarized in the accompanying table. It is noteworthy that the longest interval between the onset of influenza and death was 11 days, and, in view of the renal lesions to be described, it is of interest that in each case there was a terminal phase, lasting one to three days, characterized by severe toxaemia and peripheral circulatory failure.