Serotype 19A Bacteremic Pneumococcal Pneumonia After 4 Doses of 13-Valent Conjugate Vaccine

Tam, Pui Ying Iroh; Hanisch, Benjamin; Forward, Brennan

doi:10.1177/0009922814562550

Cited by 1 publication

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“…With the change of vaccine strategy, waning coverage can occur for serotypes that not include in the new vaccine. Vaccine failure has been reported in fully immunized children, due to serotype 3 in the parapneumonic pleural effusion context after 3 + 1 doses of PCV13 [ 12 ], but also serotype 19A in bacteremic pneumococcal pneumonia after 3 + 1 doses PCV13 [ 13 ]. There are currently no reports of PCV13 failure in preventing complicated pneumonia caused by serotype 19A among children vaccinated with the full 2 + 1 schedule.…”

Section: Discussionmentioning

confidence: 99%

A case report of parapneumonic pleural effusion caused by Streptococcus pneumoniae serotype 19A in a child immunized with 13-valent conjugate pneumococcal vaccine

et al. 2017

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BackgroundSimple parapneumonic effusion is a pleural effusion associated with lung infection (i.e., pneumonia). Streptococcus pneumoniae remains the most common pathogen causing parapneumonic effusions. In Morocco, the pneumococcal conjugate vaccine 13-valent (PCV13) was introduced in the national immunization program in October 2010 in 2 + 1 schedule for prevention of pneumococcal disease, and replaced by the PCV10 in July 2012 in the same schedule. We report a case of parapneumonic pleural effusions caused by S. pneumoniae serotype 19A in a child immunized with 3 doses of PCV13.Case presentationThis is a 2.5 years old previously healthy Moroccan female, fully vaccinated by PCV13 and immunocompetent, admitted to a private medical clinic with a six months history of persistent asthma. On arrival (7 February 2015), she was febrile to 40.3 °C with a brutal flu syndrome, chills, dry cough and serous rhinitis, for which she received symptomatic treatment. A biological assessment was done that confirmed the clinical diagnosis of flu. Seven days after, she presented a progressive deterioration of its general condition and the onset of severe abdominal pain. She was hospitalized and a second biological assessment, computed tomography scans and chest radiography were done that confirmed a diagnosis of a pneumococcal parapneumonia with abscess of the left lower lobe with encysted empyema. Microbiological analysis of the pleural fluid showed a S. pneumoniae serotype 19A with susceptibility intermediate to penicillin. The patient was treated by antibiotics including amoxicillin, cefixime ceftriaxone and vancomycin.ConclusionsWe reported a case of parapneumonic pleural effusions caused by a vaccine serotype pneumococcal 19A occurring in an immunocompetent child immunized with 3 doses of PCV13.

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Section: Discussionmentioning

confidence: 99%