Pneumococcal Sepsis Complicated by Splenic Abscesses and Purpura Fulminans in a 15-Month-Old Child

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.

Infected simple renal cyst due to Streptococcus pneumoniae rapidly diagnosed by the melting temperature mapping method: a case report

“…In addition, although relatively infrequent, pneumococcal pyelonephritis, urosepsis and urinary tract infections have been reported [ 10 , 11 ]. Metastatic pyogenic infections can occur during the course of bacteremia caused by invasive pneumococcal disease with and without underlying immunological disorders [ 12 , 13 ]. Lantinga et al [ 2 ] conducted a systematic review from 1948 to 2014 and reported that various pathogenic microorganisms, including bacteria and fungi, were causative agents according to microbiological results and pathogens isolated in renal cyst infections.…”

Septic Shock and Purpura Fulminans Due to Streptococcus pneumoniae Bacteremia in an Unvaccinated Immunocompetent Adult: Case Report and Review

“…The majority of published cases in the literature occur in those patients with some form of immunodeficiency. Only a few cases have reported this dramatic of a presentation in otherwise healthy patients [11,[35][36][37]. Asplenia is a significant risk factor, as illustrated in the case of an otherwise healthy 36-yearold mother of 2 who died 12 hours after symptom onset despite timely and appropriate therapy [38].…”