Triple Co-Infection with Influenza A, SARS-CoV-2, and Streptococcus Pneumoniae: A Case Report

Background: Viral respiratory infections can predispose patients to secondary bacterial pneumonia. It is rare for aninfection to occur concurrently with Influenza and SARS-CoV-2; adding Streptococcus pneumoniae is a rare but seriousclinical entity that is associated with significant morbidity and mortality.Case Presentation: A 58-year-old male patient, without significant comorbidities, presented with high-grade fever,productive cough, dyspnea, and altered sensorium in emergency department of Jinnah hospital, Lahore. RT-PCRperformed on nasopharyngeal swabs showed positivity for Influenza A and SARS-CoV-2. Blood culture revealed thegrowth of Streptococcus pneumoniae. Chest imaging showed features of bilateral multilobar pneumonia. He receiveda therapeutic course of antivirals, broad-spectrum antibiotics, corticosteroids, and supportive care, culminating inclinical improvement.Conclusion: This case highlights the consideration of bacterial co-infection in patients with dual viral respiratoryinfections and the need for early microbiological testing and appropriate, timely antimicrobial therapy. COVID-19,Influenza, Streptococcus pneumoniae, co-infection,