title: Late onset invasive pneumococcal disease in a liver transplanted patient: beyond the Austrian syndrome.
abstract: Invasive disease caused by Streptococcus pneumoniae is a major cause of morbidity and mortality in high-risk individuals with severe comorbidities, including asplenia, chronic alcoholism, and altered immune status. The risk of invasive pneumococcal disease has been significantly higher in transplant patients compared with the general population. Here, we report an unusual case of a disseminated pneumococcal infection with meningitis, endocarditis, spondylodiscitis, and muscle abscess in an asplenic patient on chronic immunosuppressive therapy for liver transplantation performed 17 years before.
authors.affiliation: Infectious Disease Unit, SM Goretti Hospital, Fondazione Eleonora Lorillard Spencer Cenci, Sapienza University, Latina, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Belvisi
authors.forename: C
authors.initials: C
authors.lastname: Del Borgo
authors.forename: F
authors.initials: F
authors.lastname: Morelli
authors.forename: R
authors.initials: R
authors.lastname: Marocco
authors.forename: T
authors.initials: T
authors.lastname: Tieghi
authors.forename: P
authors.initials: P
authors.lastname: Fabietti
authors.forename: A
authors.initials: A
authors.lastname: Vetica
authors.forename: M
authors.initials: M
authors.lastname: Lichtner
authors.forename: C M
authors.initials: CM
authors.lastname: Mastroianni
mesh_terms: D017668:Age of Onset; D001921:Brain / Q000000981:diagnostic imaging; D015299:Discitis / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000382:microbiology*; D004697:Endocarditis, Bacterial / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging* / Q000382:microbiology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000382:microbiology*; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000134:cerebrospinal fluid / Q000150:complications* / Q000382:microbiology; D011859:Radiography; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D014463:Ultrasonography