Unusual manifestations of invasive pneumococcal infection

Taylor, Stephanie N.; Sanders, Charles V.

doi:10.1016/s0002-9343(99)00103-5

Cited by 115 publications

(79 citation statements)

References 226 publications

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“…In summary, the present case illustrates that in middleaged or elderly patients who present with unusually severe or atypical invasive pneumococcal infections, multiple myeloma, along with other common risk factors including alcoholism, human immunodeficiency virus infection, splenectomy, connective tissue disease, corticosteroid use, diabetes mellitus and intravenous drug use (Taylor & Sanders, 1999), should be actively excluded. Aggressive therapy with appropriate anti-pneumococcal antibiotics and surgical interventions should be commenced as soon as possible as the mortality rate of the infection is high if untreated.…”

Section: Discussionmentioning

confidence: 86%

Pneumococcal native aortic valve endocarditis with mycotic abdominal aortic aneurysm, paraspinal and iliopsoas abscesses and pneumonia revealing a multiple myeloma

Chan

Hwang

Lamb

et al. 2011

Journal of Medical Microbiology

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We report a rare case of multiple myeloma presenting with native aortic valve endocarditis with secondary embolic mycotic abdominal aortic aneurysm, contiguous paraspinal and iliopsoas abscesses, and pneumonia due to Streptococcus pneumoniae in a Chinese man. He was treated with aortic valve replacement, endovascular stenting of aneurysm, image-guided drainage of abscesses, and a 6-week course of endocarditic antibiotic therapy followed by chronic suppressive antibiotic therapy. Cases of multiple myeloma presenting with invasive pneumococcal infection were reviewed.

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Section: Discussionmentioning

confidence: 86%

Pneumococcal native aortic valve endocarditis with mycotic abdominal aortic aneurysm, paraspinal and iliopsoas abscesses and pneumonia revealing a multiple myeloma

Chan

Hwang

Lamb

et al. 2011

Journal of Medical Microbiology

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“…[14] Invasive pneumococcal disease (IPD) has been described to affect almost every organ and thus the clinical manifestations and outcomes of the disease vary tremendously. [15,16] Among risk factors, older age (65 years) and immunocompromised state are notably associated with higher incidence of the invasive disease and increased mortality rates. [5] Despite modern therapy for IPD, mortality rates of invasive pneumococcal disease remain as high as 5% to 35% and the risk of death appears to peak in the first 72 hours.…”

Section: Discussionmentioning

confidence: 99%

Unusual Cause of Severe Jaundice in an HIV Infected Patient

Woytanowski¹,

Bluen²,

Maning³

et al. 2018

AJMCR

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Lobar pneumonia as a cause of jaundice with non-obstructive conjugated hyperbilirubinemia is an uncommon complication of pneumococcus. More commonly seen in immunocompromised and elderly patients, it is believed that the offending microbe produces a toxin that directly causes hepatocellular injury and impairment of bilirubin excretion. Biopsies of patients with pneumococcal pneumonia-associated jaundice commonly depict patchy areas of hepatic necrosis and dilated biliary canaliculi without metastatic foci of infection. In the pre-antibiotic era, the prevalence of jaundice in patients with lobar pneumonia was reported to be about 14% and carried significant mortality rates. Seen less commonly today, mortality rates of invasive pneumococcal disease remain as high as 5% to 35%. We present a case of a 29 year-old-male with no medical history presented with subjective fevers, productive cough, dark urine and myalgias for three days. He was profoundly jaundiced without stigmata of chronic liver disease. Computerized tomography (CT) of the chest revealed a right lower lobe pneumonia. The patient had leukocytosis, significant elevation of transaminases, hyperbilirubinemia and was found to be influenza positive. Antibody for human immunodeficiency virus (HIV) was also positive and later confirmed with polymerase chain reaction (PCR). An extensive workup for his jaundice and hyperbilirubinemia was unrevealing and it was deemed that his clinical signs were a result of invasive pneumococcal infection from his pneumonia. The patient was treated with antimicrobials and highly active antiretroviral therapy (HAART). He ultimately had complete resolution of his jaundice and laboratory abnormalities. Although seen infrequently today, unusual manifestations of pneumococcal infection still occur and may be unrecognized in practice.

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“…Se le reconoce por la tríada de meningitis, neumonía y endocarditis por S. pneumoniae (2,6,7). La condición está asociada a una alta letalidad, particularmente en pacientes inmunosuprimidos (8,9); la destrucción valvular generada por la endocarditis es el principal factor pronóstico del síndrome, el cual cursa generalmente de forma agresiva, con focos sépticos metastásicos entre los que se han descrito los siguientes: meningitis (29-60 %), neumonía (35-60 %), artritis (2-14 %), compromiso ocular, aneurisma fúngico e infartos renal y esplénico (1). El foco infeccioso principal se presenta comúnmente sobre las válvulas nativas izquierdas, siendo la válvula aórtica la localización más frecuente de las vegetaciones.…”

Section: Discussionunclassified

Infección invasiva por Streptococcus pneumoniae. Síndrome de Austrian: reporte de caso

et al. 2014

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Institución donde se realizó la investigación: Corporación Comfenalco Valle-Universidad Libre, Cali, Colombia Descrito inicialmente en 1957 por Robert Austrian, el síndrome que lleva su nombre se define como la tríada de neumonía, endocarditis y meningitis secundarias a una infección invasiva por Streptococcus pneumoniae. Desde entonces, y debido a su infrecuencia, se han reportado muy pocos casos en la literatura científica. A continuación se presenta el caso de un paciente de 61 años de edad con un cuadro inicial de meningitis bacteriana por S. pneumoniae, acompañado de neumonía bacteriana e insuficiencia mitral grave asociada a cuatro vegetaciones sobre la cara auricular de la valva posterior, con ruptura y prolapso de su festón central posterior. Se aisló S. pneumoniae, serotipo 18C, en líquido cefalorraquídeo y en dos hemocultivos. El paciente recibió antibióticos de amplio espectro y fue sometido a reemplazo valvular temprano con un resultado clínico satisfactorio. El principal factor pronóstico de esta condición lo determina el daño valvular subsecuente, sobre todo en pacientes con compromiso de la válvula aórtica, por lo que es necesario identificar tempranamente la extensión del compromiso valvular y definir oportunamente el tratamiento quirúrgico y antibiótico del paciente. En casos menos frecuentes, en los que solo hay compromiso de la válvula mitral, la evolución clínica es menos aguda y, por lo general, el tratamiento antibiótico dirigido y las medidas de soporte avanzado suelen ser suficientes para su control.

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Unusual manifestations of invasive pneumococcal infection

Cited by 115 publications

References 226 publications

Pneumococcal native aortic valve endocarditis with mycotic abdominal aortic aneurysm, paraspinal and iliopsoas abscesses and pneumonia revealing a multiple myeloma

Pneumococcal native aortic valve endocarditis with mycotic abdominal aortic aneurysm, paraspinal and iliopsoas abscesses and pneumonia revealing a multiple myeloma

Unusual Cause of Severe Jaundice in an HIV Infected Patient

Infección invasiva por Streptococcus pneumoniae. Síndrome de Austrian: reporte de caso

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