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Complications and mortality primarily occur in high-risk populations and those who are hospitalized. Severe disease and mortality are usually attributable to pneumonia from the primary viral infection or a secondary bacterial infection, [1] [11] which can progress to ARDS. [13]
Pneumonia is usually caused by infection with viruses or bacteria, and less commonly by other microorganisms. [a] Identifying the responsible pathogen can be difficult. Diagnosis is often based on symptoms and physical examination. [8] Chest X-rays, blood tests, and culture of the sputum may help confirm the diagnosis. [8]
Bleeding from the ears and petechial hemorrhages in the skin also occurred." [28] The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung. [63]
Pneumonia can be caused by a buildup of bacteria, viruses, or fungi in the lungs. There are several types of bacteria that can cause pneumonia, some typical and some atypical.
The CDC classifies flu viruses as A, B, C, and D. Types A and B are seasonal flu, and influenza A is broken down further into subtypes and strains. For example, current subtypes include H1N1 and H3N2.
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There is an association between pneumococcal pneumonia and influenza. Damage to the lining of the airways (respiratory epithelium) and upper respiratory system caused by influenza may facilitate pneumococcal entry and infection. [6] Influenza also modifies the innate immune system into a state more accommodating to pneumococcal infections. [7]
For example, an infection due to a burn or penetrating trauma (the root cause) is a secondary infection. Primary pathogens often cause primary infection and often cause secondary infection. Usually, opportunistic infections are viewed as secondary infections (because immunodeficiency or injury was the predisposing factor). [60]
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