Pneumococcal Meningitis in a Child With Sickle Cell Anemia: A Case Report

Abstract

Children with sickle cell disease are mainly exposed to various infections, among which there is bacterial meningitis. We present a brief report of a pneumococcal meningitis, due to Streptococcus pneumoniae 33F, in a 3-year-old boy of African race with sickle cell anemia. He was vaccinated against Streptococcus pneumoniae with 13-valent vaccine, and he was also on antibiotic prophylaxis. The child has been successfully treated with cephalosporins for a complete duration of 6 weeks, while hospitalization lasted about 3 weeks. Ceftriaxone was replaced by cefotaxime to avoid risk of hemolysis, as we found in literature. During recovery, the little boy presented with osteomyelitis, so vancomycin was added to therapy with good results. Finally, neurosensorial deafness was found, thus the child was quickly directed to cochlear implant intervention. This case report revealed that sometimes pneumococcal vaccination and antibiotic prophylaxis are not enough to prevent pneumococcal meningitis in children with sickle cell disease. Moreover, we noticed that cefotaxime avoids autoimmune hemolysis, which may be fatal to anemic children, while vancomycin may help to prevent complications such as osteomyelitis.

Infection and Potential Challenge of Childhood Mortality in Sickle Cell Disease: A Comprehensive Review of the Literature from a Global Perspective

“…Recently Chenou et al observed that SCD patients are 300 times more likely to develop bacterial meningitis than the normal population, and 10% of affected children die due to the infection generated by meningitis and pneumococcus [83]. Previous research found that meningitis in SCD patients caused by various bacteria, including H. influenzae, H. meningitis, and E. coli [84], and Streptococcus pneumonia, was responsible for 70% of bacterial meningitis cases in SCD children, while H. influenza was responsible for 80% [83,85]. The recurrence of meningitis occurs more frequently in SCD patients [86].…”