Severe pneumococcal pneumonia with human rhinovirus/enterovirus coinfection leading to sepsis in a welder: a case report.

Human rhinovirus/enterovirus (HRV/HEV) members of the Picornaviridae family are traditionally associated with self-limiting upper respiratory tract infections. However, increasing evidence suggests their potential to involve the lower respiratory tract and contribute to severe pulmonary disease. HRV/HEV infections are frequently complicated by bacterial coinfection and the development of complicated pneumonia. This case report presents a case of a 64-year-old male welder admitted to the intensive care unit with severe right lobar pneumonia and profound hypoxemia. Microbiological investigations confirmed invasive pneumococcal disease with Streptococcus pneumoniae bacteremia, alongside concomitant HRV/HEV infection. This viral-bacterial interplay induced a dysregulated systemic inflammatory response along with coagulopathy, respiratory failure, and other multiorgan dysfunction, fulfilling Sepsis-3 criteria. Despite early initiation of targeted intravenous antibiotic therapy, the clinical course was prolonged and fluctuating. This case highlights the potential severity of human rhinovirus/enterovirus coinfection with invasive pathogens such as Streptococcus pneumoniae, contributing to complicated pneumonia and sepsis. It also underscores the increased susceptibility of welders-particularly those with additional risk factors such as smoking and inadequate vaccination-to invasive pneumococcal disease. Early recognition of viral-bacterial coinfection and prompt management of sepsis are critical to improving clinical outcomes.