Invasive pneumococcal disease by serotype 23B in an asplenic unvaccinated patient: A case report
Abstract
Invasive pneumococcal disease (IPD) is a life-threatening infection caused by Streptococcus pneumoniae, particularly in immunocompromised individuals, such as those with asplenia. Although pneumococcal vaccination has reduced the incidence of vaccine-covered serotypes, non-vaccine serotypes, including serotype 23B, have emerged as the predominant cause of IPD. This case report describes a 67-year-old woman with asplenia who developed IPD caused by multidrug-resistant Streptococcus pneumoniae serotype 23B, which led to meningitis, septic arthritis, and endophthalmitis. The patient, who had declined pneumococcal vaccination after her splenectomy, presented with fever, pain in her left hip and right shoulder, and visual issues. The diagnosis confirmed S. pneumoniae serotype 23B, resistant to multiple antibiotics. The treatment involved a combination of vancomycin, ceftriaxone, and rifampicin, followed by vitrectomy for the eye infection. Despite severe complications, including worsening vision, the patient's vision in the right eye improved after surgery, and the joint pain subsided with long-term antibiotic therapy. This case underscores the challenges posed by non-vaccine S. pneumoniae serotypes, particularly in asplenic patients. Currently, we can use the 21-valent pneumococcal conjugate vaccine (PCV21), which includes the 23B serotype. Vaccination and early recognition, combined with a multidisciplinary treatment approach involving both antimicrobial therapy and surgical…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Photochemical behavior of levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.