Streptococcus pneumoniae Intracranial Abscess and Post-Infectious Vasculitis

Abstract

Intracranial abscesses are rare complications of Streptococcus pneumoniae infections, and to our knowledge, there have been no case reports of post-infectious vasculitis developing in such patients. Here we describe the case of a 48-year-old post-splenectomy male who developed post-infectious vasculitis following S. pneumoniae otitis media complicated by mastoiditis, osteomyelitis, meningitis, and intracranial abscess. Clinicians ought to be aware of the possible adverse outcomes of invasive S. pneumoniae and the limitations of current treatment options.

Pneumococcal Meningitis Complicated by Cerebral Vasculitis, Abscess, Hydrocephalus, and Hearing Loss

“…Although intracranial abscess after Streptococcus pneumoniae meningitis is a rare complication, the survival rate and long-term outcome are very poor, with up to 35% mortality and 40% long-term neurological sequelae [ 6 – 8 ].…”

“…Our patient has a higher risk of invasive S. pneumoniae . The majority of patients have an obvious secondary cause such as ear or sinus infections or pneumonia [ 5 , 6 ].…”

“…Streptococcus pneumoniae intracranial abscess is a rare complication of pneumococcal meningitis, with the majority of cases being reported in the preantibiotic era. Today, the survival rate and long-term outcome of these patients remain quite poor, with up to 35% mortality and 40% experiencing prolonged neurological deficits [ 6 – 8 ]. Intracranial abscesses, postinfectious vasculitis, and hydrocephalus are rare complications of S. pneumoniae meningitis, and to our knowledge, there have been no case reports where all these 3 complications occurred in a single patient with Streptococcus pneumoniae meningitis.…”

“…Intracranial abscesses, postinfectious vasculitis, and hydrocephalus are rare complications of S. pneumoniae meningitis, and to our knowledge, there have been no case reports where all these 3 complications occurred in a single patient with Streptococcus pneumoniae meningitis. There was a case report of postinfectious vasculitis and abscess of brain following Streptococcus pneumoniae meningitis [ 6 ]. Here, we report a case of a 48-year-old male with S. pneumoniae meningitis complicated by postinfectious cerebral vasculitis, intracranial abscess, hydrocephalus, hearing loss, and brain infarct.…”

Meningitis crónica autoinmune secundaria a meningitis aguda por neumococo. Caso clínico

“…También es muy frecuente la inflamación parenquimatosa difusa, como la cerebritis y más eventuales, las reacciones de estructuras ependimarias o ventriculares 4 . Esta amplia actividad inflamatoria que produce el neumococo dentro del SNC corresponde a respuestas ampliadas del sistema inmune en las infecciones neumocócicas, condición que podría generar una reactividad inmunológica tardía, capaz de inducir el desarrollo de vasculitis crónicas en las etapas postagudas de la infección [5][6][7] . Reactividad que ha sido interpretada como la perpetuación de una cascada inflamatoria independiente, causada por la desregulación en la especificidad inmunológica en ciertos pacientes 6,8 .…”