By | June 10, 2022

A superinfection is understood in medicine as a secondary infection. A bacterial infection usually follows a viral infection.

What is superinfection?

The term superinfection comes from Latin and means overinfection. In virology, the term is used for a form of virus infection of a cell. The second infection is caused by a different strain of the same pathogen. Co-infection with another virus is also possible.

Medicine mostly uses the term superinfection for a secondary infection. This is usually a viral infection followed by a bacterial infection. Sometimes the term superinfection is also used for infections that are promoted by non-infectious chronic diseases. For legionnaires’ disease in English, please visit

Typical examples of superinfection include secondary bacterial infection following viral bronchitis. There is a risk that the bronchitis will turn into a life-threatening pneumonia. But chronic circulatory disorders that occur as part of diabetes ( diabetes mellitus ) and cause ischemia of the foot can also lead to a superinfection such as a diabetic foot.

Atopic dermatitis is another example of superinfection. In this disease, which is accompanied by thinning and weakening of the skin, a secondary infection with fungi such as [[[Trichophyton]] rubrum or bacteria such as staphylococci is conceivable.


A superinfection is caused by another infection. A bacterial superinfection is a complication of a viral infection such as a common cold or flu (influenza). The common cold is always caused by viruses.

However, the bacteria can take advantage of the weakness of the human immune system during this infection and infect the diseased tissue again, which then leads to a secondary or superinfection.

Typical superinfections in the case of a flu infection are inflammation of the paranasal sinuses (sinusitis) and inflammation of the middle ear (otitis media). The pathogens get from the nose into the sinuses or from the eustachian tube (ear trumpet) into the middle ear. In addition, further secondary infections such as bronchitis, tonsillitis, pleurisy or pneumonia can occur.

The human immune system is heavily burdened by cold and flu viruses. The immune system has to find a suitable reaction to the pathogens. However, this makes it easier for the bacteria to attack, because the immune cells deal with the defense against the viruses. For example, the immune messengers are regenerated and other factors in the immune system suffer from exhaustion.

Above all, the mucous membranes in the nose and bronchi are an easy target for bacteria, since the cilia on the upper mucous membrane cells have already been destroyed by the viruses. Normally, the small hairs carry invading microbes out of the organism. However, when destroyed, the bacteria can stick and attack the second cell line, causing inflammation.

Contact with bacteria from the environment is not necessary for the outbreak of a superinfection. The germs can already be in the body, but have so far been successfully kept in check by the immune system. The virus infection then leads to an imbalance.

Symptoms, Ailments & Signs

The symptoms of an influenza superinfection always begin with the typical symptoms of a cold. These include runny nose, sore throat, cough and urge to sneeze. In the further course, other symptoms such as headaches, feelings of pressure in the paranasal sinuses or bronchitis can occur.

A typical sign of a bacterial secondary infection is a green-yellowish secretion of the affected mucosa. In addition, the affected persons often suffer from fever. In the case of a middle ear infection, earache or tinnitus appear. In addition, the patient’s feeling of illness increases and he finds it difficult to cough up.

Other secondary infections occur much less frequently, but can have dramatic consequences. With diabetes, for example, there is a risk of diabetic foot developing from poorly healing wounds. In the worst case, an operation or even an amputation may be necessary.

Diagnosis & course of disease

If there are signs such as a purulent runny nose or a purulent tonsillitis, going to the doctor is unavoidable. He will do a physical exam and look at the patient’s medical history. The tonsils are also checked for any white deposits, which are an indication of bacterial tonsillitis (tonsillitis).

Blood tests to look for markers of inflammation are also considered helpful. X-rays may be taken if pneumonia is suspected. Bronchoscopy (lung endoscopy) or computed tomography is rarely required. Superinfection increases the risk of complications. In addition, the healing process is delayed, which means that the disease lasts longer.


The so-called superinfection is itself a complication of a common cold or influenza flu. Because the patient’s immune system is weakened by the viral cold, bacteria can now infect the diseased tissue and trigger a secondary infection.

The course of a superinfection is significantly more difficult than that of a flu-like infection. Due to the bacterial complication, there is a risk of further diseases such as sinusitis (sinusitis), purulent bronchitis, middle ear infection (otitis media) or pneumonia (pneumonia). The responsible triggers are types of bacteria such as streptococci, pneumococci or staphylococci.

In an unfavorable case, pneumonia is also accompanied by the formation of lung abscesses. In order to avoid such serious consequences, the flu should always be treated in good time. The typical signs of superinfection include the appearance of purulent discharge, which has a green-yellow color.

It is not uncommon for those affected to suffer from fever. Tonsillitis (angina tonsillaris) can also occur. Another, but rather rare, complication of superinfection is inflammation of the heart muscle (myocarditis). It is caused by viruses and becomes noticeable through rapid fatigue, shortness of breath and cardiac arrhythmias.

Other conceivable consequences of the superinfection are cardiac insufficiency, pulmonary edema, in which fluid accumulates in the lungs, or circulatory collapse. Gastrointestinal diseases or meningitis (meningitis) are less common. In principle, damage to almost all organs is possible.

When should you go to the doctor?

A doctor should be consulted as soon as there is general weakness, malaise or persistent malaise. If the state of health of the person concerned decreases steadily within a short period of time, he needs medical care. A cold, cough, fever, headache or body aches are signs of a disorder that should be examined by a doctor. A continuous decrease in physical and mental performance, an increased need for sleep and disturbances in concentration or attention should be clarified by a doctor.

Ear discomfort, sputum production when coughing, loss of appetite, or lethargy should also be evaluated and treated. If the patient has already had an infection and is now in a state of renewed deterioration rather than on the road to recovery, they should inform their doctor of the changes as soon as possible.

In case of weight loss, behavioral abnormalities, irritability and general vegetative dysfunctions, a visit to the doctor is advisable. Changes in the complexion, sleep disorders, exhaustion, feelings of pressure in the paranasal sinuses and fatigue are considered to be alarming if the symptoms persist or increase over several days. The affected person needs medical care and should consult a doctor. Without medical care, complications and serious health consequences can occur.

Treatment & Therapy

Superinfection must be treated consistently. Therapeutic measures include rest, a light diet rich in vitamins, plenty of fluid intake and warmth. In addition, the doctor prescribes antibiotics that kill off the causative bacteria and support the immune system against the double burden.

It is also helpful to take herbal preparations such as sage tea, elderberry tea, soapwort, star anise, sloe and jujube. The active ingredients have an anti-inflammatory, diaphoretic and expectorant effect. Rubs with peppermint, fennel, eucalyptus, thyme and anise are also useful .

If it is a superinfection caused by skin injuries or neurodermatitis, care must be taken to ensure that the wound is treated consistently. This includes daily dressing changes and baths.


In order to prevent superinfection, it is advisable to drink plenty of fluids, sleep a lot and eat fruit and vegetables in the event of illness. On the other hand, tobacco, alcohol and sweets should be avoided during a flu infection in order to avoid additional strain on the immune system.


The superinfection is often associated with a significant weakening of the body. Targeted aftercare, which also serves long-term recovery, is therefore particularly important. It must be discussed with the family doctor and needs the patient’s input for optimal success.

A healthy lifestyle that helps the organism to regenerate itself is important. This includes adequate sleep, which has an important recovery function. It also depends on the diet. Fruit and vegetables provide valuable vitamins, minerals and trace elements. Drinking enough water is also very important. 1.5 to 2 liters of water or herbal tea are ideal.

Movement helps the circulation to stabilize again, but it should definitely be done gently in the beginning. In any case, an overload should be avoided. Often a walk is enough, which offers fresh air in addition to physical activity.

Superinfections are often treated with antibiotics, which can lead to a strain on the intestinal flora. Here it makes sense not to overload the intestines with a lavish or flatulent diet after the therapy. Probiotic food can also help the intestines to regenerate sustainably after antibiotics have been administered.

You can do that yourself

In order to improve their health, those affected can adapt their everyday life as optimally as possible to the needs of their body. A healthy and balanced diet is important to stabilize the body’s defense system. In order to cope with the pathogens, the immune system must be supported in various ways. An oxygen-rich environment is just as necessary as sufficient physical exercise.

At the same time, it is important to avoid risk factors. It is therefore generally not advisable to consume nicotine, drugs or alcohol. It is also necessary to check that there is no abuse when taking medication. If you have any questions or are unclear, you should consult a doctor. For an optimal healing process, the help and support of a doctor should be sought. In addition, natural remedies or home remedies can also be helpful to alleviate existing symptoms. If you have a sore throat, for example, honey can be perceived as pleasant.

The organism should always be protected against overuse. Avoid physical and emotional stressful situations. As soon as a feeling of illness or discomfort occurs, the organism should be given sufficient rest and protection. The sleep hygiene is to be optimized for this. The human body needs optimal sleeping conditions so that sufficient regeneration can take place. Therefore, any kind of interruption of sleep should be avoided.