A Case Report of Disseminated Complicated by Infective Endocarditis, Septic Arthritis and Epidural Abscess in an Immunocompetent Patient

Overview

Journal Access Microbiol

Specialty Microbiology

Date 2023 Aug 21

PMID 37601436

Authors

Kimberley Rose Dean

Archana Koirala

Harsha Samarasekara

Affiliations

Soon will be listed here.

Abstract

is a highly virulent, vaccine-preventable pathogen which can cause disease on a spectrum from benign to fatal. Apart from pneumonia, it commonly causes septicaemia and meningitis. This case report describes an unusual range of complications in a 53-year-old Caucasian female presenting to a regional hospital, without any risk known factors for severe disease (such as extremes of age, immunodeficiency or co-morbidities). Progressing from an episode of otitis media, her condition rapidly progressed to mastoid sinusitis, septic arthritis, infective endocarditis, epidural abscesses and multiple subcutaneous abscesses. Following quick identification of from a positive blood culture, the patient was treated with high-dose benzylpenicillin and ceftriaxone and aggressive source control by surgery, enabling a good clinical recovery.

References

Hao L, Kuttel M, Ravenscroft N, Thompson A, Prasad A, Gangolli S . Streptococcus pneumoniae serotype 15B polysaccharide conjugate elicits a cross-functional immune response against serotype 15C but not 15A. Vaccine. 2022; 40(33):4872-4880. DOI: 10.1016/j.vaccine.2022.06.041. View

Andreo F, Dominguez J, Ruiz J, Blanco S, Arellano E, Prat C . Impact of rapid urine antigen tests to determine the etiology of community-acquired pneumonia in adults. Respir Med. 2005; 100(5):884-91. DOI: 10.1016/j.rmed.2005.08.020. View

Bergenfelz C, Hakansson A . Otitis Media Pathogenesis and How It Informs Our Understanding of Vaccine Strategies. Curr Otorhinolaryngol Rep. 2017; 5(2):115-124. PMC: 5446555. DOI: 10.1007/s40136-017-0152-6. View

Perier A, Puyade M, Revest M, Tattevin P, Bernard L, Lemaignen A . Prognosis of Streptococcus pneumoniae endocarditis in France, a multicenter observational study (2000-2015). Int J Cardiol. 2019; 288:102-106. DOI: 10.1016/j.ijcard.2019.04.048. View

Daudin M, Tattevin P, Lelong B, Flecher E, Lavoue S, Piau C . Characteristics and prognosis of pneumococcal endocarditis: a case-control study. Clin Microbiol Infect. 2016; 22(6):572.e5-8. DOI: 10.1016/j.cmi.2016.03.011. View

Petti C, Woods C, Reller L . Streptococcus pneumoniae antigen test using positive blood culture bottles as an alternative method to diagnose pneumococcal bacteremia. J Clin Microbiol. 2005; 43(5):2510-2. PMC: 1153727. DOI: 10.1128/JCM.43.5.2510-2512.2005. View

Charkaluk M, Kalach N, Mvogo H, Dehecq E, Magentie H, Raymond J . Assessment of a rapid urinary antigen detection by an immunochromatographic test for diagnosis of pneumococcal infection in children. Diagn Microbiol Infect Dis. 2006; 55(2):89-94. DOI: 10.1016/j.diagmicrobio.2005.10.013. View

Song J . Advances in pneumococcal antibiotic resistance. Expert Rev Respir Med. 2013; 7(5):491-8. DOI: 10.1586/17476348.2013.816572. View

Randle E, Ninis N, Inwald D . Invasive pneumococcal disease. Arch Dis Child Educ Pract Ed. 2011; 96(5):183-90. DOI: 10.1136/adc.2010.191718. View

10.

Gaschignard J, Levy C, Chrabieh M, Boisson B, Bost-Bru C, Dauger S . Invasive pneumococcal disease in children can reveal a primary immunodeficiency. Clin Infect Dis. 2014; 59(2):244-51. PMC: 4102913. DOI: 10.1093/cid/ciu274. View

11.

Marrie T, Tyrrell G, Majumdar S, Eurich D . Risk factors for pneumococcal endocarditis. Eur J Clin Microbiol Infect Dis. 2017; 37(2):277-280. DOI: 10.1007/s10096-017-3128-z. View

12.

Mackenzie G, Carapetis J, Leach A, Morris P . Pneumococcal vaccination and otitis media in Australian Aboriginal infants: comparison of two birth cohorts before and after introduction of vaccination. BMC Pediatr. 2009; 9:14. PMC: 2656498. DOI: 10.1186/1471-2431-9-14. View

13.

Perdrizet J, Farkouh R, Horn E, Hayford K, Sings H, Wasserman M . The broader impacts of otitis media and sequelae for informing economic evaluations of pneumococcal conjugate vaccines. Expert Rev Vaccines. 2022; 21(4):499-511. DOI: 10.1080/14760584.2022.2040989. View

14.

Roy S, Knox K, Segal S, Griffiths D, Moore C, Welsh K . MBL genotype and risk of invasive pneumococcal disease: a case-control study. Lancet. 2002; 359(9317):1569-73. DOI: 10.1016/S0140-6736(02)08516-1. View

15.

van Hoek A, Andrews N, Waight P, George R, Miller E . Effect of serotype on focus and mortality of invasive pneumococcal disease: coverage of different vaccines and insight into non-vaccine serotypes. PLoS One. 2012; 7(7):e39150. PMC: 3398022. DOI: 10.1371/journal.pone.0039150. View

16.

Colaco C, OSullivan M, Zhang H, Huynh D, Sintchenko V, Oftadeh S . Pneumococcal bacteraemia in adults over a 10-year period (2011-2020): a clinical and serotype analysis. Intern Med J. 2023; 53(11):2028-2034. DOI: 10.1111/imj.16045. View

17.

West D, McCauley L, Sorensen J, Jephson A, Dean N . Pneumococcal urinary antigen test use in diagnosis and treatment of pneumonia in seven Utah hospitals. ERJ Open Res. 2017; 2(4). PMC: 5152836. DOI: 10.1183/23120541.00011-2016. View

18.

Pichichero M, Malley R, Kaur R, Zagursky R, Anderson P . Acute otitis media pneumococcal disease burden and nasopharyngeal colonization in children due to serotypes included and not included in current and new pneumococcal conjugate vaccines. Expert Rev Vaccines. 2022; 22(1):118-138. DOI: 10.1080/14760584.2023.2162506. View

19.

Yamanaka N, Hotomi M, Billal D . Clinical bacteriology and immunology in acute otitis media in children. J Infect Chemother. 2008; 14(3):180-7. DOI: 10.1007/s10156-007-0599-3. View

20.

Erdem H, Elaldi N, Oztoprak N, Sengoz G, Ak O, Kaya S . Mortality indicators in pneumococcal meningitis: therapeutic implications. Int J Infect Dis. 2013; 19:13-9. DOI: 10.1016/j.ijid.2013.09.012. View