Recurrent severe invasive pneumococcal disease in an adult with previously unknown hyposplenia.

Abstract:

BACKGROUND:The risk of life-threatening and invasive infections with encapsulated bacteria is increased in patients with hyposplenia or asplenia. We report a case of recurrent invasive pneumococcal meningitis in a woman with previous unknown hyposplenia. She was vaccinated after the first episode of meningitis and developed sufficient levels of pneumococcal antibodies. The pneumococcal strains isolated were serotype 7 F and 17 F. To our knowledge, there has been no previously reported case of recurrent invasive pneumococcal disease in a pneumococcal vaccinated adult with hyposplenia and apparently sufficient antibody response. CASE PRESENTATION:We report the course of a 38-year-old Caucasian woman presenting with recurrent episodes of invasive pneumococcal disease (IPD) and previously unknown hyposplenia. Hyposplenia was discovered during the second episode of IPD and no underlying medical condition was found. Despite immunization against S. pneumoniae and measurement of what was interpreted as protective levels of serotype-specific IgG antibodies after vaccination, the patient suffered from a third episode of IPD. CONCLUSIONS:Individuals with predisposing medical conditions or a history of severe infections with encapsulated bacteria should be screened for spleen dysfunction. If splenic function is impaired, prevention against severe invasive infection with encapsulated bacteria are a major priority.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Ballegaard VC,Schejbel L,Hoffmann S,Kantsø B,Fischer CP

doi

10.1186/s12879-015-0883-2

subject

Has Abstract

pub_date

2015-04-02 00:00:00

pages

171

issn

1471-2334

pii

10.1186/s12879-015-0883-2

journal_volume

15

pub_type

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