Prolonged Shedding of Multidrug-Resistant Influenza A Virus in an Immunocompromised Patient

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Abstract
Immunocompromised patients can persistently shed influenza, increasing the potential for resistance to antiviral drugs and for nosocomial transmission.1,2 We report the case of a 23-year-old man with acute lymphocytic leukemia who underwent transplantation of T-cell–depleted hematopoietic stem cells from his HLA-mismatched brother in August 1999 after receiving total body irradiation, thiotepa, fludarabine, and antithymocyte globulin. After transplantation, graft-versus-host disease developed (requiring treatment with prednisone and azathioprine), along with transplant-related nephropathy, avascular necrosis in both ankles, and restrictive lung disease.