title: Fatal overwhelming postsplenectomy infection caused by Streptococcus pneumoniae in mothers within 1 year after delivery: case report.
abstract: Invasive pneumococcal disease (IPD) has a high mortality. Although preventive strategies including vaccination have been established for children, less attention has been devoted to pregnant and postnatal women and to mothers caring for their infants. As a significant number of women have either undergone splenectomy or are in a hyposplenic state and have not received adequate pneumococcal vaccinations, they can potentially develop overwhelming postsplenectomy infections. A 34-year-old woman with an 8-month-old baby, who underwent splenectomy at the age of 10 for benign pancreatic tumor, presented with fever and petechial eruption. Despite extensive treatment, she died 17 h after admission. A 40-year-old woman with a 11-month-old baby, who underwent splenectomy at 2 years of age for hemolytic anemia, was admitted for septic shock and disseminated intravascular coagulation. Despite extensive treatment, she died 2 h after admission. Blood cultures from both women were positive for Streptococcus pneumoniae and neither of them had been vaccinated against the bacterium. IPD rapidly progressed and developed to multiple organ dysfunction syndromes in mothers caring for their infants, particularly those who had undergone splenectomy or were in a hyposplenic state. Thus, routine pneumococcal vaccination is recommended for pregnant women. In addition, we suggest a thorough medical interview and checkup for splenectomy or hyposplenism in prenatal women.
authors.affiliation: Division of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, 3256 Midori-cho, Tachikawa, Tokyo, 190-0014, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Hifumi
authors.forename: Seitaro
authors.initials: S
authors.lastname: Fujishima
authors.forename: Bin
authors.initials: B
authors.lastname: Chang
authors.forename: Junichi
authors.initials: J
authors.lastname: Sasaki
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kiriu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kato
authors.forename: Junichi
authors.initials: J
authors.lastname: Inoue
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Koido
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000382:microbiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009035:Mothers; D011008:Pneumococcal Infections / Q000209:etiology* / Q000382:microbiology; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011183:Postoperative Complications / Q000382:microbiology; D013156:Splenectomy / Q000009:adverse effects*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
chemical_list: D022242:Pneumococcal Vaccines