Pneumococcal infection transmission between family members with congenital asplenia: A case report

Abstract

BACKGROUNDAsplenia, the lack of a spleen, can be congenital and increases susceptibility to severe infections caused by encapsulated bacteria, such as Streptococcus pneumoniae (S. pneumoniae). We report two cases of severe pneumococcal infection in two asplenic family members living in the same household.CASE SUMMARYPatient 1, a 38-year-old man with a history of congenital hepatitis B infection and hypospadias, was brought to our emergency department with complaints of cyanosis, cough, and edema of his limbs. He was clinically diagnosed as hyposplenic with overwhelming pneumococcal sepsis. He was admitted to the intensive care unit and was administered antibiotics and catecholaminergic therapy but died 2 h after admission. Patient 2, a 63-year-old woman with a history of type 2 diabetes, was brought to our emergency department one month after admission of Patient 1. She was diagnosed as asplenic with overwhelming pneumococcal sepsis. History-taking revealed that she was the mother of Patient 1 and the two had lived in the same household. She was admitted to the intensive care unit and was rapidly provided antibiotics and catecholaminergic intervention but died one day after admission.CONCLUSIONPneumococcal bacteremia caused by virulent S. pneumoniae may be transmitted within households. All residents of households where individuals with pneumococcal bacteremia are living should be educated about the risk of transmissibility. Family members of patients with congenital asplenia/hyposplenia, all family members should be examined to assess their splenic function.

Streptococcus pneumoniae Infection in Patients with Asplenia: A Spanish Perspective over a 25-Year Period

“…Patients with asplenia are also at risk for less common infections due to malaria, Babesia, and Capnocytophaga [15]. The most important pathogen is SP, which accounts for 40-60% of cases in splenectomized patients [5]. This could form the basis of new studies that complement what was described and increase knowledge about the risk of SP infection.…”

“…For this, the prevention of infection is essential. Non-splenectomized patients should be vaccinated with the PCV and, in general, all patients with asplenia should consider vaccination, the use of prophylactic antibiotics, and knowing when to seek medical care [5].…”

“…The appearance of cases due to non-susceptible serotypes has great clinical relevance due to Antibiotics 2024, 13, 104 2 of 13 these cases' higher lethality. When SP infection is suspected in a patient with asplenia, intravenous antibiotics should be immediately administrated with no delay, and even diagnostic studies are needed [5]. Nonetheless, the fatality rates are high despite the use of antibiotics (in overwhelming sepsis, the fatality rates are 40-50%).…”