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Kalizang'oma A, Richard D, Kwambana-Adams B, Coelho J, Broughton K, Pichon B, Hopkins KL, Chalker V, Beleza S, Bentley SD, Chaguza C, Heyderman RS. Population genomics of Streptococcus mitis in UK and Ireland bloodstream infection and infective endocarditis cases. Nat Commun 2024; 15:7812. [PMID: 39242612 PMCID: PMC11379897 DOI: 10.1038/s41467-024-52120-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 08/27/2024] [Indexed: 09/09/2024] Open
Abstract
Streptococcus mitis is a leading cause of infective endocarditis (IE). However, our understanding of the genomic epidemiology and pathogenicity of IE-associated S. mitis is hampered by low IE incidence. Here we use whole genome sequencing of 129 S. mitis bloodstream infection (BSI) isolates collected between 2001-2016 from clinically diagnosed IE cases in the UK to investigate genetic diversity, antimicrobial resistance, and pathogenicity. We show high genetic diversity of IE-associated S. mitis with virtually all isolates belonging to distinct lineages indicating no predominance of specific lineages. Additionally, we find a highly variable distribution of known pneumococcal virulence genes among the isolates, some of which are overrepresented in disease when compared to carriage strains. Our findings suggest that S. mitis in patients with clinically diagnosed IE is not primarily caused by specific hypervirulent or antimicrobial resistant lineages, highlighting the accidental pathogenic nature of S. mitis in patients with clinically diagnosed IE.
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Affiliation(s)
- Akuzike Kalizang'oma
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection & Immunity, University College London, London, UK. akuzike.kalizang'
- Malawi Liverpool Wellcome Programme, Blantyre, Malawi. akuzike.kalizang'
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre, Malawi. akuzike.kalizang'
| | - Damien Richard
- UCL Genetics Institute, University College London, London, UK
| | - Brenda Kwambana-Adams
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection & Immunity, University College London, London, UK
- Malawi Liverpool Wellcome Programme, Blantyre, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Juliana Coelho
- Public Health Microbiology Division, UK Health Security Agency, Colindale, London, UK
| | - Karen Broughton
- Public Health Microbiology Division, UK Health Security Agency, Colindale, London, UK
| | - Bruno Pichon
- Public Health Microbiology Division, UK Health Security Agency, Colindale, London, UK
| | - Katie L Hopkins
- Public Health Microbiology Division, UK Health Security Agency, Colindale, London, UK
| | | | - Sandra Beleza
- University of Leicester, Department of Genetics and Genome Biology, Leicester, UK
| | | | - Chrispin Chaguza
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection & Immunity, University College London, London, UK
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, UK
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Robert S Heyderman
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection & Immunity, University College London, London, UK.
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Grant LR, Meche A, McGrath L, Miles A, Alfred T, Yan Q, Chilson E. Risk of Pneumococcal Disease in US Adults by Age and Risk Profile. Open Forum Infect Dis 2023; 10:ofad192. [PMID: 37180598 PMCID: PMC10167987 DOI: 10.1093/ofid/ofad192] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/07/2023] [Indexed: 05/16/2023] Open
Abstract
Background Older age and certain medical conditions are known to modify the risk of pneumococcal disease among adults. We quantified the risk of pneumococcal disease among adults with and without medical conditions in the United States between 2016 and 2019. Methods This retrospective cohort study used administrative health claims data from Optum's de-identified Clinformatics Data Mart Database. Incidence rates of pneumococcal disease-all-cause pneumonia, invasive pneumococcal disease (IPD), and pneumococcal pneumonia-were estimated by age group, risk profile (healthy, chronic, other, and immunocompromising medical condition), and individual medical condition. Rate ratios and 95% CIs were calculated comparing adults with risk conditions with age-stratified healthy counterparts. Results Among adults aged 18-49 years, 50-64 years, and ≥65 years, the rates of all-cause pneumonia per 100 000 patient-years were 953, 2679, and 6930, respectively. For the 3 age groups, the rate ratios of adults with any chronic medical condition vs healthy counterparts were 2.9 (95% CI, 2.8-2.9), 3.3 (95% CI, 3.2-3.3), and 3.2 (95% CI, 3.2-3.2), while the rate ratios of adults with any immunocompromising condition vs healthy counterparts were 4.2 (95% CI, 4.1-4.3), 5.8 (95% CI, 5.7-5.9), and 5.3 (95% CI, 5.3-5.4). Similar trends were observed for IPD and pneumococcal pneumonia. Persons with other medical conditions, such as obesity, obstructive sleep apnea, and neurologic disorders, were associated with increased risk of pneumococcal disease. Conclusions The risk of pneumococcal disease was high among older adults and adults with certain risk conditions, particularly immunocompromising conditions.
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Affiliation(s)
- Lindsay R Grant
- Medical Development & Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, Pennsylvania, USA
| | - Aster Meche
- Real World Evidence, Center of Excellence, Pfizer Inc, New York, New York, USA
| | - Leah McGrath
- Real World Evidence, Center of Excellence, Pfizer Inc, New York, New York, USA
| | - Amanda Miles
- Real World Evidence, Center of Excellence, Pfizer Inc, New York, New York, USA
| | - Tamuno Alfred
- Statistical Research and Data Science Center, Pfizer Inc, New York, New York, USA
| | - Qi Yan
- Medical Development & Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, Pennsylvania, USA
| | - Erica Chilson
- Medical Development & Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, Pennsylvania, USA
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Muacevic A, Adler JR, Cunha L, Cordeiro I, Baptista A. Invasive Pneumococcal Disease and COVID-19 Coinfection: A Series of Cases Admitted to an Intensive Care Unit. Cureus 2022; 14:e31876. [PMID: 36579230 PMCID: PMC9790083 DOI: 10.7759/cureus.31876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 11/26/2022] Open
Abstract
Pneumococcal infection is still a frequent disease. It can be classified as invasive when pneumococcus is isolated in a generally sterile fluid. Pneumonia is the most common infectious source of adult invasive pneumococcal disease (IPD), and several risk factors for IPD are well known. This case report presents three clinical cases of different manifestations of IPD. The two most severe cases had coinfection by SARS-CoV-2 at hospital admission.
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Chowdhury ZM, Bhattacharjee A, Ahammad I, Hossain MU, Jaber AA, Rahman A, Dev PC, Salimullah M, Keya CA. Exploration of Streptococcus core genome to reveal druggable targets and novel therapeutics against S. pneumoniae. PLoS One 2022; 17:e0272945. [PMID: 35980906 PMCID: PMC9387852 DOI: 10.1371/journal.pone.0272945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022] Open
Abstract
Streptococcus pneumoniae (S. pneumoniae), the major etiological agent of community-acquired pneumonia (CAP) contributes significantly to the global burden of infectious diseases which is getting resistant day by day. Nearly 30% of the S. pneumoniae genomes encode hypothetical proteins (HPs), and better understandings of these HPs in virulence and pathogenicity plausibly decipher new treatments. Some of the HPs are present across many Streptococcus species, systematic assessment of these unexplored HPs will disclose prospective drug targets. In this study, through a stringent bioinformatics analysis of the core genome and proteome of S. pneumoniae PCS8235, we identified and analyzed 28 HPs that are common in many Streptococcus species and might have a potential role in the virulence or pathogenesis of the bacteria. Functional annotations of the proteins were conducted based on the physicochemical properties, subcellular localization, virulence prediction, protein-protein interactions, and identification of essential genes, to find potentially druggable proteins among 28 HPs. The majority of the HPs are involved in bacterial transcription and translation. Besides, some of them were homologs of enzymes, binding proteins, transporters, and regulators. Protein-protein interactions revealed HP PCS8235_RS05845 made the highest interactions with other HPs and also has TRP structural motif along with virulent and pathogenic properties indicating it has critical cellular functions and might go under unconventional protein secretions. The second highest interacting protein HP PCS8235_RS02595 interacts with the Regulator of chromosomal segregation (RocS) which participates in chromosome segregation and nucleoid protection in S. pneumoniae. In this interacting network, 54% of protein members have virulent properties and 40% contain pathogenic properties. Among them, most of these proteins circulate in the cytoplasmic area and have hydrophilic properties. Finally, molecular docking and dynamics simulation demonstrated that the antimalarial drug Artenimol can act as a drug repurposing candidate against HP PCS8235_RS 04650 of S. pneumoniae. Hence, the present study could aid in drugs against S. pneumoniae.
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Affiliation(s)
| | | | - Ishtiaque Ahammad
- Bioinformatics Division, National Institute of Biotechnology, Dhaka, Bangladesh
| | | | - Abdullah All Jaber
- Department of Biochemistry & Microbiology, North South University, Dhaka, Bangladesh
| | - Anisur Rahman
- Bioinformatics Division, National Institute of Biotechnology, Dhaka, Bangladesh
| | | | - Md. Salimullah
- Molecular Biotechnology Division, National Institute of Biotechnology, Dhaka, Bangladesh
| | - Chaman Ara Keya
- Department of Biochemistry & Microbiology, North South University, Dhaka, Bangladesh
- * E-mail:
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Brant Pinheiro SV, de Freitas VB, de Castro GV, Rufino Madeiro BC, de Araújo SA, Silva Ribeiro TF, Simões E Silva AC. Acute Post-Streptococcal Glomerulonephritis In Children: A Comprehensive Review. Curr Med Chem 2022; 29:5543-5559. [PMID: 35702785 DOI: 10.2174/0929867329666220613103316] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/23/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Acute post-streptococcal glomerulonephritis (APSGN) is an immune-complex (ICs) mediated glomerular disease triggered by group A β-hemolytic streptococcus (GAS) or Streptococcus pyogenes infections. APSGN represents a major cause of acquired kidney injury in children. METHODS This non-systematic review summarizes recent evidence on APSGN. We discuss the epidemiology, pathogenesis, clinical and laboratory findings, histopathology, treatment and prognosis of the disease. RESULTS The median APSGN incidence in children in developing countries is estimated at 24.3/100,000 per year, compared with 6.2/100,000 per year in developed countries. Nephritis-associated plasmin receptor, identified as glyceraldehyde-3-phosphate dehydrogenase, and the cationic cysteine proteinase streptococcal pyrogenic exotoxin B are thought to be two leading streptococcal antigens involved in the pathogenesis of APSGN, which activate the complement system, mainly via the alternative but also the lectin pathway. This process is critical for the generation of inflammation by the ICs deposited in the glomerulus. The classic phenotype is an acute diffuse proliferative glomerulonephritis leading to features of the nephritic syndrome including hematuria, oliguria, hypertension and edema. The histopathology shows that the glomeruli are diffused affected, mostly presenting enlarged glomerular tuffs due to hypercellularity. Proliferative endothelial and mesangial cells and inflammation are also observed. APSGN frequently has spontaneous recovery. There is no specific therapy, but its morbidity and mortality are drastically reduced by the prevention and/or treatment of complications. CONCLUSION Despite recent advances, the pathogenesis of APSGN is not fully understood. There is no specific treatment for APSGN. The prognosis is generally good. However some cases may evolve to chronic kidney disease.
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Affiliation(s)
- Sérgio Veloso Brant Pinheiro
- Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Victor Buchini de Freitas
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | - Gustavo Valverde de Castro
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | | | | | - Thomas Felipe Silva Ribeiro
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Belo Horizonte, MG, Brazil
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6
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Jiang M, Wang X, Zhu L, Yang YH, Yao KH, Dong F, Shi W, Wang Q, Song WQ, Liu G. Clinical characteristics, antimicrobial resistance, and risk factors for mortality in paediatric invasive pneumococcal disease in Beijing, 2012-2017. BMC Infect Dis 2022; 22:338. [PMID: 35382757 PMCID: PMC8981664 DOI: 10.1186/s12879-022-07179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 02/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background To analyse clinical characteristics, antibiotic susceptibility, and risk factors for mortality in paediatric invasive pneumococcal disease (IPD) in Beijing. Methods Paediatric IPD patients in our hospital were retrospectively collected from 2012 to 2017. Clinical manifestations, laboratory tests, antimicrobial susceptibility and serotype of isolates, and risk factors for mortality of IPD were analysed. Results Overall, 186 IPD cases were enrolled. The major manifestations were meningitis (76), pneumonia with bacteraemia (60), bacteraemia without focus (21), and pneumonia with empyaema (22). Of 72 cases with underlying diseases, leukaemia (18.0%), congenital heart disease (15.3%), primary immunodeficiency disease (12.5%), nephrotic syndrome (12.5%), and cerebrospinal fluid leakage (12.5%) were most common. In total 96.9% of isolates would have been covered by the pneumococcal conjugate vaccine (PCV13), including 19F (32.8%), 19A (23.4%), 4 (17.2%), and 23F (9.4%). Nonsusceptibility rates of penicillin, cefotaxime, and cefepime among nonmeningitis patients increased between 2012 and 2017; The mortality rate was 21.5%. Meningitis, respiratory failure, multiple organ failure, and white blood cell count < 4000 cells/μL were independent risk factors for mortality. Conclusion Meningitis was the most common clinical manifestation of IPD, and was frequently associated with death. Strains in the PCV13 vaccine would cover most of the cases, and so wider use of PCV13 should be considered.
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Affiliation(s)
- Man Jiang
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China.,Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518035, China
| | - Xi Wang
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China
| | - Liang Zhu
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China
| | - Yong-Hong Yang
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Kai-Hu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Fang Dong
- Department of Laboratory Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Wei Shi
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Qing Wang
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Wen-Qi Song
- Department of Laboratory Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Gang Liu
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China.
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7
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A Rare Case of Pneumococcal Appendicitis in a Child. Case Rep Pediatr 2022; 2022:9262149. [PMID: 35178265 PMCID: PMC8843964 DOI: 10.1155/2022/9262149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/25/2021] [Accepted: 01/20/2022] [Indexed: 11/21/2022] Open
Abstract
Appendicitis is the most common cause for abdominal surgery in children. It is usually caused by Escherichia coli and Streptococcus species and is generally polymicrobial. However, Streptococcus pneumoniae is a rare cause of appendicitis. We report a rare case of pneumococcal appendicitis in a 7-year-old child with no underlying conditions, in association with E. coli and group F β-hemolytic Streptococcus. The isolated pneumococcal strain was sensible to all tested antibiotics. The patient had a full recovery after surgery and antibiotics. This case emphasizes that S. pneumoniae can cause a variety of unusual infections like appendicitis, in patients with or without underlying conditions. Thus, even though being a rare entity, physicians should always be aware of S. pneumoniae as a possible causative agent.
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Uejima Y, Niimi H, Kato R, Furuichi M, Sato S, Kitajima I, Kawano Y, Oh-Ishi T, Kawashima H, Suganuma E. Infected simple renal cyst due to Streptococcus pneumoniae rapidly diagnosed by the melting temperature mapping method: a case report. BMC Pediatr 2021; 21:265. [PMID: 34090356 PMCID: PMC8178924 DOI: 10.1186/s12887-021-02736-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Spontaneous infection of preexisting solitary renal cysts has been documented in adults but is extremely rare in children. To date, no cases of simple renal cysts infected with Streptococcus pneumoniae have been described. Recently, reports have described the diagnosis of bacterial infection using the 16 S rRNA gene as well as the accompanying antimicrobial stewardship for microorganisms that are difficult to culture and for culture-negative cases after preceding antibacterial administration. Case presentation A four-year-old Japanese girl who had a pleuroperitoneal shunt inserted to drain a right pleural effusion due to occlusion of the hepatic portion of the inferior vena cava at three years old visited our hospital due to fever and respiratory discomfort. She was incidentally found to have a right simple renal cyst 10 months before admission. The patient was suspected to have pneumonitis or catheter-related blood stream infection on chest X-ray, which showed right-side pleural effusion. She was diagnosed with invasive pneumococcal infection, as Streptococcus pneumoniae was detected from blood culture on admission. Transient improvements in her symptoms and decreases in the white blood cell count and C-reactive protein level were observed after effective antibiotic administration, but her respiratory condition deteriorated. Enhanced CT showed right renal cyst enlargement and enhancement and thickening of the surrounding wall. Using the melting temperature (Tm) mapping method, S. pneumoniae was rapidly detected directly from pus 4.5 hours after drainage. The specimen culture was negative, but the extracted 16 S rDNA sequence revealed 100 % identity for S. pneumoniae from the same specimen the subsequent day. We successfully performed optimal treatment and reduced medical cost based on the positive Tm mapping method result. Conclusions We report the first case of a S. pneumoniae-infected simple renal cyst. The drainage culture was negative, but the Tm mapping method rapidly detected S. pneumoniae directly from the drainage. The Tm mapping method may have great impacts on rapid diagnosis and effective antimicrobial stewardship.
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Affiliation(s)
- Yoji Uejima
- Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuou-ku, 330-8777, Saitama, Japan. .,Department of Clinical Laboratory and Molecular Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan.
| | - Hideki Niimi
- Department of Clinical Laboratory and Molecular Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Reiko Kato
- Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Mihoko Furuichi
- Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuou-ku, 330-8777, Saitama, Japan
| | - Satoshi Sato
- Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuou-ku, 330-8777, Saitama, Japan
| | - Isao Kitajima
- Department of Clinical Laboratory and Molecular Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Yutaka Kawano
- Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuou-ku, 330-8777, Saitama, Japan
| | - Tsutomu Oh-Ishi
- Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuou-ku, 330-8777, Saitama, Japan
| | - Hiroshi Kawashima
- Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Eisuke Suganuma
- Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuou-ku, 330-8777, Saitama, Japan
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Machiavello Roman F. A case of pneumococcal tricuspid endocarditis: An oslerian diagnosis. IDCases 2021; 24:e01155. [PMID: 34026542 PMCID: PMC8134731 DOI: 10.1016/j.idcr.2021.e01155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 11/25/2022] Open
Abstract
Pneumococcal endocarditis is a rare manifestation of S. pneumoniae infection. It affects mainly middle-aged men without traditional risk factors for IE. Isolates have high sensitivity to penicillin, but cardiac complications are common.
Streptococcal infections present in a variety of clinical syndromes. Invasive disease, such as infective endocarditis, was common in the pre-antibiotic era but is now seldom encountered. The author reports the case of an elderly man with pneumococcal tricuspid endocarditis presenting with fever and syncope, and reviews current literature regarding the epidemiology, clinical features and treatment of this condition.
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10
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de Leau MM, Kuipers RS. Cardiovascular complications of Streptococcus pneumoniae bacteraemia. BMJ Case Rep 2021; 14:e240341. [PMID: 33827874 PMCID: PMC8030674 DOI: 10.1136/bcr-2020-240341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 11/03/2022] Open
Abstract
The incidence of Streptococcus pneumoniae bacteraemia has risen due to a worldwide increase in immunocompromised patients and antibiotic resistance. We describe three patients who experienced severe, including cardiovascular, complications of pneumococcal bacteraemia. Cardiovascular complications related to pneumococci may run a fulminant course. However, some of these life-threatening complications (eg, endocarditis and aortitis) may long remain unnoticed or be misdiagnosed and therefore delay correct treatment. We review the literature with regards to the incidence, diagnosis and treatment of these rare but possibly lethal and hence important cardiovascular complications.
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Affiliation(s)
- Michelle M de Leau
- Heart Center, department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Remko S Kuipers
- Heart Center, department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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Rodriguez-Iturbe B. Autoimmunity in Acute Poststreptococcal GN: A Neglected Aspect of the Disease. J Am Soc Nephrol 2021; 32:534-542. [PMID: 33531351 PMCID: PMC7920173 DOI: 10.1681/asn.2020081228] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Acute poststreptococcal GN (APSGN) is the prototype of immune complex GN and is associated with manifestations of autoimmune reactivity that have been neglected as epiphenomena. Recently, studies have demonstrated transient antifactor B autoantibodies that activate the alternative complement pathway, bringing self-immunity to a central position in the pathogenesis of APSGN. Therefore, examining other manifestations of autoimmunity that have been reported in association with poststreptococcal GN is of interest. This article reviews the renal and extrarenal manifestations of autoimmune reactivity in APSGN and considers their potential relevance in modifying the usually benign clinical course of the disease. It also discusses related aspects of the nephritogenic antigens, complement activation, and genetic elements associated with immune reactivity and their potential relevance to the familial incidence of the disease.
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Affiliation(s)
- Bernardo Rodriguez-Iturbe
- Department of Nephrology, Instituto Nacional de Nutrición y Ciencias Médicas "Salvador Zubirán" and Instituto Nacional de Cardiología "Ignacio Chávez," Mexico City, Mexico
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12
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Berlinrut I, Koshy R. Epididymitis associated with bacteremic pneumococcal pneumonia. IDCases 2021; 23:e01054. [PMID: 33552901 PMCID: PMC7851768 DOI: 10.1016/j.idcr.2021.e01054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022] Open
Abstract
We describe a case of a 56 year-old male who presented to the hospital with pneumonia and bacteremia secondary to Streptococcus pneumoniae. After admission and initiation of appropriate antibacterial therapy he began to complain of scrotal pain. Ultrasound of the testes confirmed findings of left-sided epididymitis. Urine culture, urine gonorrhea and chlamydia nucleic acid amplification and HIV testing were negative. Clinical picture suggested seeding of the epididymis with Streptococcus pneumoniae and resulting infection.
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Affiliation(s)
- Ilan Berlinrut
- Infectious Diseases, Northwell Health, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
| | - Robin Koshy
- Infectious Diseases, Northwell Health, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
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13
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Govindaswamy A, Sagar S, Trikha V, Mittal S, Malhotra R, Mathur P. Atypical case presentations of Streptococcus pneumoniae from level 1 trauma centre in India -A case series. J Family Med Prim Care 2020; 9:5058-5061. [PMID: 33209846 PMCID: PMC7652198 DOI: 10.4103/jfmpc.jfmpc_529_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/26/2020] [Accepted: 06/03/2020] [Indexed: 11/16/2022] Open
Abstract
Streptococcus pneumoniae is a rare cause of appendicitis, skin soft tissue, and bloodstream infections. The clinical significance of its isolation from samples of skin or soft tissues and pus from the appendix is poorly understood. Invasive pneumococcal disease (IPD) continues to be a problem in India, associated with a high case fatality rate despite treatment facilities available in the hospital settings. In the present study, we report three adult cases, one presented as acute appendicitis, the other had skin and soft tissue infection, and third presented with bloodstream infection caused by Streptococcus pneumoniae from our level 1 trauma center. The patients with acute appendicitis and soft tissue infection recovered when treated with appropriate antimicrobial therapy, however, the one with pneumococcal sepsis could not be revived.
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Affiliation(s)
- Aishwarya Govindaswamy
- Department of Microbiology, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Sushma Sagar
- Department of Trauma and Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Trikha
- Orthopedics, All India Institute of Medical Sciences, New Delhi, India
| | - Samarth Mittal
- Orthopedics, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Malhotra
- Orthopedics, All India Institute of Medical Sciences, New Delhi, India
| | - Purva Mathur
- Department of Microbiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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Liver Abscess due to Streptococcus pneumoniae: A Clinical Rarity. Case Rep Infect Dis 2020; 2020:1572023. [PMID: 32566332 PMCID: PMC7288222 DOI: 10.1155/2020/1572023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/13/2020] [Accepted: 05/18/2020] [Indexed: 11/17/2022] Open
Abstract
We report a case of pyogenic liver abscess caused by a rare causative agent, Streptococcus pneumoniae. A 45-year-old man with underlying uncontrolled diabetes mellitus who had stopped taking his daily dose of insulin since the last 4 days, presented with pain in the abdominal area of one-day duration. Upon his admission to achieve diabetic control, a routine ultrasound examination of abdomen revealed incidentally, a large abscess in the left lobe of the liver with impending rupture. Culture of the ultrasound-guided liver aspirate pus yielded pure growth of a penicillin-susceptible S. pneumoniae isolate. After 4 weeks of parenteral ceftriaxone therapy along with intensive regimen for diabetic control, the liver abscess became resolved, and the patient improved and was discharged with no residual infection or recurrence at four months and at one-year follow-up. A review of relevant literature related to S. pneumoniae liver abscess revealed a mention of such entity only on 4 previous occasions. The present case highlights an important though rare manifestation of S. pneumoniae infection and emphasizes the need to establish an early diagnosis of S. pneumoniae infection for improved patient survival and favourable outcome.
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Ishiguro T, Uozumi R, Yoshioka H, Nishida T, Takayanagi N. Comparison between Patients with Chest Infection due to Klebsiella spp. and Streptococcus pneumoniae. Intern Med 2020; 59:611-618. [PMID: 31761885 PMCID: PMC7086319 DOI: 10.2169/internalmedicine.3531-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/14/2019] [Indexed: 11/06/2022] Open
Abstract
Objective In Japan, the aging demographic structure is becoming pronounced, and the full-blown graying of society appears not far off, which indicates an increasing population that will require healthcare contact. Klebsiella spp. are major pathogens in healthcare-associated infections, and their importance is increasing. The aim of this study was to clarify the characteristics of Klebsiella spp. chest infections by evaluating the differences in the characteristics of chest infections caused by Klebsiella spp. and pneumoniae. Methods We conducted a retrospective study of consecutive patients hospitalized with pneumonia, lung abscess/necrotizing pneumonia, and empyema due to Klebsiella spp. and S. pneumoniae for 15 years at our institution in Saitama, Japan. Patients Patients with chest infections due to Klebsiella spp. (K group, n=76) and S. pneumoniae (S group, n=446) were included. Results The K group more frequently was male, older, coinfected by Pseudomonas aeruginosa, and had diabetes mellitus, a history of upper digestive system surgery, alcohol drinking habit, a smoking habit, and an impaired premorbid performance status than the S group. The percentages of lung abscesses or necrotizing pneumonia (31.6% vs. 0.9%) and empyema without pulmonary parenchymal shadow (3.9% vs. 0.7%) were higher in the K group than those in the S group. Severity on admission and mortality did not differ between the groups; however, patients in the K group required a longer duration of antibiotics administration and hospital stay than those in the S group. Conclusion Klebsiella spp. chest infections have some marked characteristics when compared with pneumococcal infections, and our results serve to differentiate Klebsiella spp. infection from pneumococcal infection.
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Affiliation(s)
- Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Japan
| | - Hiroaki Yoshioka
- Department of Laboratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Takashi Nishida
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Noboru Takayanagi
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
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Garris R, Abanoub R, Qaqa F, Rana C, Guragai N, Habib HA, Shamoon F, Bikkina M. Conquering the pneumococcal nemesis with oral antibiotics. J Community Hosp Intern Med Perspect 2020; 10:65-68. [PMID: 32128062 PMCID: PMC7034445 DOI: 10.1080/20009666.2019.1708637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 12/12/2019] [Indexed: 11/28/2022] Open
Abstract
Introduction: Streptococcus pneumoniae endocarditis (SPE) occurs in <3% of all EI cases due to the evolution of penicillin and vaccination. However, immunocompromised and unvaccinated patients are still at grave risk. Case: A 58-year-old African American male who used alcohol and intravenous (IV) drugs presented with confusion, fever, and hemoptysis. He had coarse rhonchi with a grade 2/5 holosystolic apical murmur. CT chest showed diffuse bilateral infiltrates. Blood cultures were positive for pansensitive Streptococcus pneumoniae. Echocardiogram demonstrated large vegetations on the anterior and posterior leaflets of the mitral valve with flail leaflet and severe eccentric mitral regurgitation. Patient was started on IV ceftriaxone, but after 3 weeks of therapy, he wished to leave against medical advice. He was discharged on combination oral therapy with successful resolution of SPE on follow-up. Discussion: Invasive pneumococcus is highly virulent causing irreversible valvular destruction or death. IV beta-lactams are first-line treatment, but there are currently no guideline-recommended alternatives for oral therapy. Recent data suggest partial oral therapy may be noninferior to IV only therapy. Conclusion: Switching to oral combination antibiotics after at least 2 weeks of IV therapy is an acceptable alternative to treat SPE.
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Affiliation(s)
- Rana Garris
- Department of Internal Medicine, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
| | - Rushdy Abanoub
- Department of Cardiology, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
| | - Firas Qaqa
- Department of Cardiology, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
| | - Chirag Rana
- Department of Cardiology, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
| | - Nirmal Guragai
- Department of Cardiology, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
| | - Habib A. Habib
- Department of Cardiology, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
| | - Fayez Shamoon
- Department of Cardiology, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
| | - Mahesh Bikkina
- Department of Cardiology, St. Joseph’s University, New York Medical College, Paterson, NJ, USA
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17
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Pneumococcal Bacteremia Complicated by Hemophagocytic Lymphohistiocytosis. J Gen Intern Med 2019; 34:1653-1657. [PMID: 31011972 PMCID: PMC6667527 DOI: 10.1007/s11606-019-05001-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/29/2018] [Accepted: 03/05/2019] [Indexed: 10/27/2022]
Abstract
From pneumonia to pericarditis, from sepsis to splenic abscess, Streptococcus pneumoniae is the causative agent of a diverse array of pyogenic disease. With the introduction of vaccines and effective antibiotic treatments, the incidence of complicated streptococcal infection has declined. We report a case of S. pneumoniae bacteremia, in the setting of occult sinusitis, complicated by hemophagocytic lymphohistiocytosis (HLH), disseminated intravascular coagulation (DIC), and recurrent pneumococcal infection. Although severe streptococcal infection has been associated with immunodeficiency or splenectomy, no such predisposition was identified in our patient. We discuss the association of streptococcal infection with HLH and DIC and review occult sinusitis as a source of pneumococcal bacteremia, with the goal of enhancing the "illness scripts" of general medical practitioners to include such entities.
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18
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Zheng S, Soh JXJ, Shafi H. Quadruple valve infective endocarditis presenting with suspected Austrian syndrome: a case report and a case series of quadruple valve infective endocarditis. Diagn Microbiol Infect Dis 2018; 94:60-65. [PMID: 30583882 DOI: 10.1016/j.diagmicrobio.2018.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/20/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Austrian syndrome comprises the triad of pneumonia, meningitis, and endocarditis secondary to Streptococcus pneumonia. We present what we believe to be the first reported case of Austrian syndrome with quadruple heart valve involvement and review the literature detailing cases of quadruple valve infective endocarditis. CASE PRESENTATION AND RESULTS A case is presented of a patient with radiographic evidence of a left lower lobe pneumonia. Sequential transthoracic followed by transesophageal echocardiogram done to evaluate the presence of a cardiac murmur revealed the presence of quadruple valve vegetations. Multiple blood cultures were persistently negative. The patient went on to develop seizures secondary to proven meningitis. Microbiological diagnosis was eventually established through positive Streptococcus pneumoniae antigen (Alere BinaxNOW®) from cerebrospinal fluid, establishing a presumptive clinical diagnosis of Austrian syndrome. A computerized PubMed search for reports of quadruple valve infective endocarditis and their references was collated. A total of 22 patients were found, including our patient. The median age of presentation was 47.5 years. Five patients had a history of intravenous drug abuse, another 5 had underlying congenital heart disease, and 1 had both. Two patients (9.1%) had 2 microorganisms isolated. Staphylococcus aureus and Streptococcus viridans (3 cases, 13.6% each) were the most commonly implicated microorganism. Heart failure was the commonest complication, afflicting 11 patients (50.0%). Ten patients (45.5%) underwent surgery. Overall case fatality rate was 50.0%. Cardiac surgery was of statistical significance in predicting survival (P = 0.009). CONCLUSION Quadruple valve endocarditis is associated with a high mortality rate, and cardiac surgery may be protective.
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Affiliation(s)
- Shuwei Zheng
- Department of Infectious Diseases, Singapore General Hospital, Outram Road, Singapore 169608.
| | - Jade Xiao Jue Soh
- Department of General Medicine, Sengkang General Hospital, 110 Sengkang E Way, Singapore 544886
| | - Humaira Shafi
- Division of Infectious Diseases, Changi General Hospital, 2 Simei Street 3, Singapore 529889
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19
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Pancoast’s syndrome: an unusual presentation of invasive pneumococcal disease. Infection 2018; 46:735-736. [DOI: 10.1007/s15010-018-1119-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
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20
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Sousa A, Pérez-Rodríguez MT, Nodar A, Martínez-Lamas L, Vasallo FJ, Álvarez-Fernández M, Crespo M. Clinical and microbiological characteristics of unusual manifestations of invasive pneumococcal disease. Enferm Infecc Microbiol Clin 2018. [DOI: 10.1016/j.eimc.2017.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Maharaj S, Seegobin K, Chrzanowski S, Chang S. Acute glomerulonephritis secondary to Streptococcus anginosus. BMJ Case Rep 2018. [PMID: 29523515 DOI: 10.1136/bcr-2017-223314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Streptococcus anginosus is a clinically important pathogen that is emerging globally but remains poorly investigated. Here, we report the first case of acute glomerulonephritis resulting from infection with S. anginosus Glomerulonephritis is typically caused by S. pyogenes and reports secondary to other strains including S. zooepidemicus and S. constellatus exist. Infection with S. anginosus in this patient was associated with acute nephritis (haematuria, oedema and hypertension), nephrotic syndrome and progressive azotemia. There was activation of the complement system. The presence of low C1q and elevated anti-C1q binding complexes points to a potential pathogenic role. Testing for streptococcal antigens was strongly positive. Emerging nephritogenic strains of S. anginosus present a significant health concern for both developed and developing countries.
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Affiliation(s)
- Satish Maharaj
- Internal Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Karan Seegobin
- College of Medicine, University of Florida, Gainesville, Florida, USA
| | | | - Simone Chang
- Hotz Children's Hospital, Jackson Health Sysrem, Miami, Florida, USA
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22
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Unusual presentation of Streptococcus pneumoniae infection as a chest wall abscess. JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.394145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pawar NH, Nickalls OJ, Tan KL, Ho VK, Ng SY, Loh J. Invasive Streptococcus Pneumoniae Infection Causing Cardioembolic Stroke: A Clinical Proximity to Austrian Syndrome. Cureus 2017; 9:e1960. [PMID: 29487774 PMCID: PMC5815650 DOI: 10.7759/cureus.1960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Streptococcus pneumoniae (S. pneumoniae) is a significant human bacterial pathogen and the major cause of pneumonia. In the post-antibiotic era, S. pneumoniae endocarditis is rare but carries a high risk of central nervous system (CNS) involvement. We present a case of invasive S. pneumoniae infection, which led to a cardioembolic stroke in a young man from septic emboli. Diagnosing a disseminated S. pneumoniae infection at an early stage is crucial and may improve patient outcomes.
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Affiliation(s)
- Nilesh H Pawar
- Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore
| | - Oliver J Nickalls
- Department of Radiology, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore
| | - Keng Leong Tan
- Department of Respiratory and Critical Care Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore
| | - Vui K Ho
- Department of Surgical Intensive Care, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore
| | - Shin Yi Ng
- Department of Surgical Intensive Care, Division of Anaesthesiology and Perioperative Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore
| | - Jiashen Loh
- Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore
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24
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Woytanowski JR, Hakim N, Deering C, Schultz S. A Case of Invasive Pneumococcal Infection with Septic Shock and Rare Complications. Case Rep Crit Care 2017; 2017:9503654. [PMID: 29181204 PMCID: PMC5664263 DOI: 10.1155/2017/9503654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 09/24/2017] [Indexed: 11/18/2022] Open
Abstract
Invasive pneumococcus is a serious illness with potentially devastating outcomes. A 64-year-old female with a medical history of psoriatic arthritis and diabetes was transferred from an outside hospital for ventilator dependent respiratory failure and altered mental status. She initially presented with worsening back pain and was found to have leukocytosis with bandemia and acute renal failure but she was in septic shock upon arrival to our tertiary care center. Her blood cultures grew Streptococcus pneumoniae and MRI of the brain revealed pus within the posterior lateral ventricles and multiple infarcts. MRI of the spine revealed a psoas abscess. Transesophageal echocardiogram revealed mitral valve vegetation and her right eye developed endogenous endophthalmitis. She was treated with intravenous and intravitreal antibiotics and underwent drainage of the abscess with no improvement in mental status. Repeat imaging revealed multiple new thalamic, basal ganglia, and parietal lobe infarcts likely from septic emboli. After a protracted ICU stay, the patient's family opted for comfort care. The incidence of invasive pneumococcal infections has declined rapidly since the advent of antibiotics and vaccines. With the growing incidence of antibiotic resistance as well as the emergence of new immunomodulating drugs for various pathologies, there is a concern that invasive infections will reemerge. Ventriculitis and endogenous endophthalmitis are very rare complications of pneumococcal bacteremia.
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Affiliation(s)
- John R. Woytanowski
- Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Nausheen Hakim
- Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Caytlin Deering
- Department of Infectious Disease and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Sara Schultz
- Department of Infectious Disease and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
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Morioka H, Iguchi M, Oodate M, Yoneda M, Ushijima F, Hirabayashi A, Tetsuka N, Tomita Y, Kato D, Yagi T. Pneumococcal biliary tract infections - How rare are they? J Infect Chemother 2016; 23:415-418. [PMID: 28024739 DOI: 10.1016/j.jiac.2016.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/30/2016] [Accepted: 11/21/2016] [Indexed: 12/16/2022]
Abstract
Pneumococcal biliary tract infections (PBTIs) were reported as rare due to the bacterium's bile solubility. The purpose of this study was to determine the occurrence and clinical characteristics of PBTIs. A retrospective case series review was conducted from January 2006 to August 2014 at a tertiary referral university hospital in Japan. Patients with a blood or bile culture positive for Streptococcus pneumoniae diagnosed with definite cholangitis or cholecystitis according to Tokyo Guideline 2013 were enrolled in this study. Data on clinical information, treatments, and outcomes were collected. During 104 months, 48 cases of positive blood cultures and 13 cases of positive bile cultures were recorded, and after excluding 43 and 5 of these, respectively, a total of 10 patients were diagnosed with PBTI. Most patients (9/10) had biliary tract problems and biliary devices in place. PBTIs were not rare; conversely, they were a relatively common cause of pneumococcal bacteremia in this center treating a high volume of biliary tract illnesses.
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Affiliation(s)
- Hiroshi Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan
| | - Mitsutaka Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Japan
| | - Mitsuru Oodate
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan; Department of Bacteriology, Nagoya University Graduate School of Medicine, Japan
| | - Masaki Yoneda
- Department of Psychiatry, Nagoya University Hospital, Japan
| | - Futoshi Ushijima
- Department of Respiratory Medicine and Clinical Immunology, Toyota Kosei Hospital, Japan
| | - Aki Hirabayashi
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan
| | - Nobuyuki Tetsuka
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan
| | - Yuka Tomita
- Department of Infectious Diseases, Nagoya University Hospital, Japan
| | - Daizo Kato
- Department of Infectious Diseases, Nagoya University Hospital, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan.
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Wada H, Ogita M, Miyauchi K, Suwa S, Yamano M, Daida H. Case report: Fulminant myocarditis associated with overwhelming pneumococcal infection. Int J Cardiol 2016; 223:706-707. [PMID: 27568994 DOI: 10.1016/j.ijcard.2016.08.282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 08/14/2016] [Accepted: 08/17/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Hideki Wada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Manabu Ogita
- Department of Cardiology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka, 410-2295, Japan.
| | - Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Satoru Suwa
- Department of Cardiology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka, 410-2295, Japan
| | - Miki Yamano
- Digestive Disease Center, Showa University, Northern Yokohama Hospital, 35-1 Chigasakityuo, Tsuzuki-ku, Yokohama, Kanagawa, 224-0032, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Berical AC, Harris D, Dela Cruz CS, Possick JD. Pneumococcal Vaccination Strategies. An Update and Perspective. Ann Am Thorac Soc 2016; 13:933-44. [PMID: 27088424 PMCID: PMC5461988 DOI: 10.1513/annalsats.201511-778fr] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/23/2016] [Indexed: 11/20/2022] Open
Abstract
Streptococcus pneumoniae is an important global pathogen that causes a wide range of clinical disease in children and adults. Pneumococcal pneumonia is by far the common presentation of noninvasive and invasive pneumococcal disease and affects the young, the elderly, and the immunocompromised disproportionately. Patients with chronic pulmonary diseases are also at higher risk for pneumococcal infections. Substantial progress over the century has been made in the understanding of pneumococcal immunobiology and the prevention of invasive pneumococcal disease through vaccination. Currently, two pneumococcal vaccines are available for individuals at risk of pneumococcal disease: the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the 13-valent pneumococcal protein-conjugate vaccine (PCV13). The goal of pneumococcal vaccination is to stimulate effective antipneumococcal antibody and mucosal immunity response and immunological memory. Vaccination of infants and young children with pneumococcal conjugate vaccine has led to significant decrease in nasal carriage rates and pneumococcal disease in all age groups. Recent pneumococcal vaccine indication and schedule recommendations on the basis of age and risk factors are outlined in this Focused Review. As new pneumococcal vaccine recommendations are being followed, continued efforts are needed to address the vaccine efficacy in the waning immunity of the ever-aging population, the implementation of vaccines using two different vaccines under very specific schedules and their real world clinical and cost effectiveness, and the development of next generation pneumococcal vaccines.
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Affiliation(s)
- Andrew C Berical
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Drew Harris
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Charles S Dela Cruz
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Jennifer D Possick
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
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Kim T, Hong SI, Park SY, Jung J, Chong YP, Kim SH, Lee SO, Kim YS, Woo JH, Lim YS, Sung H, Kim MN, Choi SH. Clinical Features and Outcomes of Spontaneous Bacterial Peritonitis Caused by Streptococcus pneumoniae: A Matched Case-Control Study. Medicine (Baltimore) 2016; 95:e3796. [PMID: 27258513 PMCID: PMC4900721 DOI: 10.1097/md.0000000000003796] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Streptococcus pneumoniae is a well-known cause of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. However, little information is available regarding clinical characteristics and outcomes of SBP caused by S. pneumoniae. It has been suggested that spontaneous pneumococcal peritonitis (SPP) often spreads hematogenously from concomitant pneumococcal pneumonia, and is associated with a higher rate of mortality.During the period between January 1997 and December 2013, 50 SPP cases were identified. These cases were then age/sex-matched with 100 patients with SBP due to causes other than S. pneumoniae (controls).SPP accounted for 4.3% (50/1172) of all culture-proven SBPs. The baseline Child-Pugh class, etiology of cirrhosis, and model for end-stage liver disease scores were comparable for the 2 groups. SPP patients were more likely than control patients to have a community-acquired infection (90.0% vs. 76.0%; P = 0.04), concurrent bacteremia (84.0% vs. 59.0%; P = 0.002), and to present with variceal bleeding (10.0% vs. 1.0%; P = 0.02). None of the study patients had pneumococcal pneumonia. The most common initial empirical therapy for both groups was third-generation cephalosporins (96.0% vs. 91.0%; P = 0.34) which was active against a significantly higher proportion of the cases than of the controls (97.8% vs. 78.7%; P = 0.003). Thirty-day mortality was significantly lower in the case group than in the control group (10.0% vs. 24.0%; P = 0.04).SPP was not associated with pneumococcal pneumonia and showed lower mortality than SBP caused by other organisms. However, the present study was constrained by the natural limitations characteristic of a small, retrospective study. Therefore, large-scale, well-controlled studies are required to demonstrate the influence of SPP on mortality, which was marginal in the present study.
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Affiliation(s)
- Taeeun Kim
- From the Department of Infectious Diseases (TK, SIH, SYP, JJ, YPC, S-HK, S-OL, YSK, JHW, S-HC); Department of Gastroenterology (Y-SL); and Department of Laboratory Medicine (HS, M-NK), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Pangonis S, Patamasucon P, Fitzpatrick E. Pneumococcal Sepsis Complicated by Splenic Abscesses and Purpura Fulminans in a 15-Month-Old Child: Case Report and Review of the Literature. J Investig Med High Impact Case Rep 2016; 4:2324709616636398. [PMID: 27006958 PMCID: PMC4784234 DOI: 10.1177/2324709616636398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 11/27/2022] Open
Abstract
Streptococcus pneumoniae is an invasive organism that causes a wide range of common diseases, including sinusitis, acute otitis media, and pneumonia. Splenic abscesses and purpura fulminans (PF) are rare complications of pneumococcal disease. Splenic abscesses caused by S pneumoniae have only been reported in the adult literature. PF has been described in the pediatric population as a rare complication in patients with invasive pneumococcal disease (IPD) with and without underlying immunological disorders such as asplenia. Here, we report a patient with IPD complicated by splenic abscesses and PF. Our patient initially presented with bacteremia, septic shock, and disseminated intravascular coagulation. She subsequently developed PF and splenic abscesses. She survived her illness after receiving a total of 8 weeks of antibiotic therapy. This case highlights 2 rare complications of IPD and demonstrates the need to keep pneumococcal disease in the differential diagnosis even in children whose vaccination status is up to date.
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Affiliation(s)
- Scott Pangonis
- University of Nevada School of Medicine, Las Vegas, NV, USA
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Zachariah D, Manga P. HIV and invasive pneumococcal infection. Int J Cardiol 2015; 198:157-8. [DOI: 10.1016/j.ijcard.2015.06.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 06/27/2015] [Indexed: 10/23/2022]
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31
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The Case of the “Chocolate” Blood Culture. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2015. [DOI: 10.1097/ipc.0000000000000215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Roberts AL, Hewlett AL, Yu J, Nahm MH, Fey PD, Iwen PC. Streptococcus pneumoniae serotype 6C presenting as recurrent prosthetic knee joint infection in a patient with a history of congenital asplenia and underlying autoimmune disease: a case report and literature review. Diagn Microbiol Infect Dis 2013; 77:376-9. [DOI: 10.1016/j.diagmicrobio.2013.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 10/26/2022]
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Ribeiro S, Domingues V, Faria RM, Mendonça T. Invasive pneumococcal disease complicated by cerebral vasculitis, transient diabetes insipidus and spondylodiscitis. BMJ Case Rep 2013; 2013:bcr-2013-010336. [PMID: 23960149 DOI: 10.1136/bcr-2013-010336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Invasive pneumococcal disease (IPD) is a potential life-threatening situation that requires immediate recognition and treatment. Cerebrovascular complications are uncommon and have been reported less frequently in adults than in children. We report a case of 59-year-old man with IPD complicated by cerebral vasculitis, transient central diabetes insipidus and spondylodiscitis. Each of these complications is rare and needs specific approach. Their association is even rarer and to the best of our knowledge this is the first case reported.
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Affiliation(s)
- Sofia Ribeiro
- Department of Medicine, Hospital Santo António, Porto, Portugal.
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Abstract
Pneumococcus is one of the most common bacterial pathogens encountered in medicine. This article summarizes the risk factors, pathogenesis, treatment, and prevention of the spectrum of disease caused by pneumococcus with particular emphasis on antibiotic resistance as well as immunization. This information is useful for physicians caring for patients both as inpatients and outpatients as well as for those concerned with public health and disease prevention.
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Affiliation(s)
- Samuel Y Ash
- Department of Medicine, University of Washington Medical Center, 1959 Northeast Pacific Street, Box 356421, Seattle, WA 98195, USA.
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Pneumococcal Meningitis in an Adolescent with Fever and Foot Ache. Case Rep Pediatr 2013; 2013:516746. [PMID: 23956909 PMCID: PMC3728537 DOI: 10.1155/2013/516746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/02/2013] [Indexed: 11/18/2022] Open
Abstract
Invasive pneumococcal disease predominantly affects younger children, elderly, and immunocompromised patients. Pneumococcal meningitis is a particularly important form of presentation, considering its high rate of morbimortality.
We present the case of a previously healthy 12-year-old adolescent male who was hospitalized due to suspicion of osteoarticular infection in his left foot. A few hours later, he developed meningeal signs, exhibiting slight pleocytosis and Streptococcus pneumoniae isolates in both cerebrospinal fluid and blood. Imaging studies were inconclusive regarding the nature of the foot disorder. We considered the hypothesis of osteomyelitis of the navicular bone as the most likely, for which he completed six weeks of antibiotic therapy. There was a favorable clinical evolution, along with complete absence of osteoarticular or neurological sequelae.
The relevance of this clinical case resides in the unusual presentation of invasive pneumococcal disease in this age group, as well as in the rare form of orthopedic involvement.
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Renal Infarction as a Presentation of Austrian Syndrome: Thromboembolic Phenomenon of Pneumococcal Endocarditis. Am J Med Sci 2012; 344:251-4. [DOI: 10.1097/maj.0b013e318254ed7e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Pediatric Case Report of Chronic Colitis Associated With an Unusual Serotype of Streptococcus pneumoniae. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2012. [DOI: 10.1097/ipc.0b013e318248f122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chan JFW, Hwang GYY, Lamb S, Chan GSW, So JCC, Leung SSM, To KKW, Li IWS, Cheng VCC, Yuen KY. Pneumococcal native aortic valve endocarditis with mycotic abdominal aortic aneurysm, paraspinal and iliopsoas abscesses and pneumonia revealing a multiple myeloma. J Med Microbiol 2011; 60:851-855. [DOI: 10.1099/jmm.0.028191-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jasper F. W. Chan
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Gloria Y. Y. Hwang
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Sophia Lamb
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Gavin S. W. Chan
- Department of Pathology and Clinical Biochemistry, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Jason C. C. So
- Department of Pathology and Clinical Biochemistry, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Sally S. M. Leung
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Kelvin K. W. To
- Carol Yu Centre for Infection, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Iris W. S. Li
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Vincent C. C. Cheng
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
| | - Kwok-Yung Yuen
- Carol Yu Centre for Infection, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR
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Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 2011; 65 Suppl 3:iii11-24. [PMID: 20876624 DOI: 10.1093/jac/dkq303] [Citation(s) in RCA: 329] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Spondylodiscitis, a term encompassing vertebral osteomyelitis, spondylitis and discitis, is the main manifestation of haematogenous osteomyelitis in patients aged over 50 years. Staphylococcus aureus is the predominant pathogen, accounting for about half of non-tuberculous cases. Diagnosis is difficult and often delayed or missed due to the rarity of the disease and the high frequency of low back pain in the general population. In this review of the published literature, we found no randomized trials on treatment and studies were too heterogeneous to allow comparison. Improvements in surgical and radiological techniques and the discovery of antimicrobial therapy have transformed the outlook for patients with this condition, but morbidity remains significant. Randomized trials are needed to assess optimal treatment duration, route of administration, and the role of combination therapy and newer agents.
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Affiliation(s)
- Theodore Gouliouris
- Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge CB2 0QW, UK.
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Park SY, Park SY, Moon SY, Son JS, Lee MS. Fatal necrotizing fasciitis due to Streptococcus pneumoniae: a case report. J Korean Med Sci 2011; 26:131-4. [PMID: 21218041 PMCID: PMC3012837 DOI: 10.3346/jkms.2011.26.1.131] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 08/03/2010] [Indexed: 11/20/2022] Open
Abstract
Necrotizing fasciitis is known to be a highly lethal infection of deep-seated subcutaneous tissue and superficial fascia. Reports of necrotizing fasciitis due to Streptococcus pneumoniae are exceedingly rare. We report a case of necrotizing fasciitis in a 62-yr-old man with liver cirrhosis and diabetes mellitus. He presented with painful swelling of left leg and right hand. On the day of admission, compartment syndrome was aggravated and the patient underwent surgical exploration. Intra-operative findings revealed necrotizing fasciitis and cultures of two blood samples and wound aspirates showed S. pneumoniae. The patient died despite debridement and proper antimicrobial treatment. To the best of our knowledge, this is the first case of fatal necrotizing fasciitis with meningitis reported in Korea. We also review and discuss the literature on pneumococcal necrotizing fasciitis.
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Affiliation(s)
- So-Youn Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - So Young Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Soo-youn Moon
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jun Seong Son
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Mi Suk Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
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41
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Austrian Syndrome (Triad of Pneumococcal Pneumonia, Meningitis and Endocarditis) in an Intravenous Drug User. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2010. [DOI: 10.1097/ipc.0b013e3181db807f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Streptococcus pneumoniae Pulmonic Valve Endocarditis in a Patient With Human Immunodeficiency Virus Infection/Acquired Immunodeficiency Syndrome. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2010. [DOI: 10.1097/ipc.0b013e3181c2980d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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43
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Urrutia A, Santesmases J, Benítez RM, Areal J. Adrenal gland abscess due to Streptococcus pneumoniae. J Infect 2010; 60:88-9. [DOI: 10.1016/j.jinf.2009.10.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 10/22/2009] [Accepted: 10/26/2009] [Indexed: 10/20/2022]
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44
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Park JY, Hwang EJ, Park SY, Moon SY, Son JS, Lee MS. A Case of Pneumococcal Endocarditis Accompanied by Arthritis and Meningitis. Infect Chemother 2010. [DOI: 10.3947/ic.2010.42.5.307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ji Young Park
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Eun Jung Hwang
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - So-Youn Park
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Soo-Youn Moon
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jun Seong Son
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Mi Suk Lee
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
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YAMASHIRO E, ASATO Y, TAIRA K, AWAZAWA R, YAMAMOTO YI, HAGIWARA K, TAMAKI H, UEZATO H. Necrotizing fasciitis caused byStreptococcus pneumoniae. J Dermatol 2009; 36:298-305. [DOI: 10.1111/j.1346-8138.2009.00643.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Necrotizing epiglottitis in an infant: an unusual first presentation of human immunodeficiency virus infection. Pediatr Infect Dis J 2009; 28:164-6. [PMID: 19106777 DOI: 10.1097/inf.0b013e318187a869] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We describe the case of a 4-month-old infant presenting with severe respiratory distress secondary to necrotizing epiglottitis, who was subsequently diagnosed with human immunodeficiency virus infection. Additionally, we review the existing literature on this rare condition with a focus on the potential underlying pathogenesis.
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47
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Vindas-Cordero JP, Sands M, Sanchez W. Austrian's triad complicated by suppurative pericarditis and cardiac tamponade: a case report and review of the literature. Int J Infect Dis 2009; 13:e23-5. [DOI: 10.1016/j.ijid.2008.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 04/16/2008] [Accepted: 04/17/2008] [Indexed: 11/15/2022] Open
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48
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Gandhi T, Wu AH, Aronoff DM. Severe transient cardiomyopathy associated with community-acquired pneumonia caused by Streptococcus pneumoniae. Heart Lung 2008; 37:394-7. [DOI: 10.1016/j.hrtlng.2007.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Accepted: 07/24/2007] [Indexed: 11/24/2022]
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49
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Vilà de Muga M, Pineda Solas V, Loverdos Eseverri I, Pérez Sánchez J, San Vicente Vela B, Argemí Renom S. Vaginitis recurrente y peritonitis por Streptococcus pneumoniae en niña prepuberal. An Pediatr (Barc) 2008; 68:627-8. [DOI: 10.1157/13123301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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50
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Tena D, Leal F, Pozo B, Bisquert J. Bilateral testicular abscess due to Streptococcus pneumoniae. Int J Infect Dis 2008; 12:343-4. [PMID: 18023386 DOI: 10.1016/j.ijid.2007.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 07/17/2007] [Accepted: 09/16/2007] [Indexed: 10/22/2022] Open
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