Necrotizing pneumonia and acute purulent pericarditis caused by Streptococcus pneumoniae serotype 19A in a healthy 4-year-old girl after one catch-up dose of 13-valent pneumococcal conjugate vaccine.
Streptococcus pneumoniae is a common cause of infectious diseases in children that may lead to life-threatening complications. Acute purulent pericarditis is an uncommon complication of S. pneumoniae in the antibiotic era. A healthy 4-year-old girl was admitted with pneumonia and pleural effusion. She had received one catch-up dose of 13-valent pneumococcal conjugate vaccine at 2 years of age. She rapidly developed necrotizing pneumonia, complicated by bronchopleural fistula presenting as subcutaneous emphysema and pneumothorax and acute purulent pericarditis. S. pneumoniae serotype 19A was subsequently identified from blood, empyema and pericardial fluid cultures. After appropriate antibiotic therapy and a right lower lobectomy, her condition stabilized and she promptly recovered. This case highlights two rare potential clinical complications of pneumococcal disease in a child: necrotizing pneumonia and acute purulent pericarditis. This is the first report of a child who received just one catch-up dose of 13-valent pneumococcal conjugate vaccine at 2 years of age, as per the United States' Advisory Committee on Immunization Practice's recommendations, but who still developed severe invasive pneumococcal disease with life-threatening complications caused by S. pneumoniae serotype 19A.
a Department of Paediatrics , Chung Shan Medical University Hospital.
Shay
S
Lu
a Department of Paediatrics , Chung Shan Medical University Hospital.|b School of Medicine , Chung Shan Medical University.
Jeng-Dau
JD
Tsai
b School of Medicine , Chung Shan Medical University.|c Department of Medical Imaging , Chung Shan Medical University Hospital , Taichung , Taiwan.
Ten-Fu
TF
Tsao
a Department of Paediatrics , Chung Shan Medical University Hospital.|b School of Medicine , Chung Shan Medical University.
Pei-Fen
PF
Liao
a Department of Paediatrics , Chung Shan Medical University Hospital.|b School of Medicine , Chung Shan Medical University.
Ji-Nan
JN
Sheu
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010493:Pericarditis / Q000188:drug therapy / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011013:Pneumonectomy / Q000379:methods; D000071067:Pneumonia, Necrotizing / Q000188:drug therapy / Q000382:microbiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
C538862:13-valent pneumococcal vaccine; D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines
13-valent pneumococcal conjugate vaccine; Acute purulent pericarditis; Bronchopleural fistula; Necrotizing pneumonia; Streptococcus pneumoniae serotype 19A