Fulminant Pneumococcal Meningoencephalitis and Widespread Cerebritis with Multiple Infarctions Caused by Non–PCV13-Serotype 23A in a 12-Month-Old Girl with Down Syndrome

Lukas Schröder; Gunnar T. R. Hischebeth; Mark van der Linden; Mark Born; Heiko Reutter; Till Dresbach; Andreas Müller

doi:10.1055/s-0036-1579748

Journal of Pediatric Infectious Diseases, Inhaltsverzeichnis

J Pediatr Infect Dis 2015; 10(03): 085-088
DOI: 10.1055/s-0036-1579748

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Fulminant Pneumococcal Meningoencephalitis and Widespread Cerebritis with Multiple Infarctions Caused by Non–PCV13-Serotype 23A in a 12-Month-Old Girl with Down Syndrome

Lukas Schröder

¹Department of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

,

Gunnar T. R. Hischebeth

²Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany

,

Mark van der Linden

³Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Aachen, Aachen, Germany

,

Mark Born

⁴Department of Radiology, Pediatric Radiology, University Hospital Bonn, Bonn, Germany

,

Heiko Reutter

¹Department of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

,

Till Dresbach

¹Department of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

,

Andreas Müller

¹Department of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

› Institutsangaben

Abstract

Streptococcus pneumoniae is one of the major pathogens in invasive diseases in children worldwide. The implementation of national vaccine programs has led to a significant reduction in most circulating pathogenic serotypes. Because of genetic shifts and replacements in the S. pneumoniae population, rare and nonvaccine serotypes have increased in prevalence. We report a case of a 12-month-old girl with Down syndrome and congenital heart disease, suffering from a fulminant pneumococcal meningoencephalitis caused by the nonvaccine serotype 23A. This nonvaccine serotype is an example of the increasing incidence in children with invasive pneumococcal disease (IPD) and illustrates the need for pneumococcal vaccines with broader coverage. Cranial computed tomography (CCT) findings of the patient revealed unusual and extended lesions with bi-hemispheric infarctions and cerebritis, with subsequent widespread intraparenchymal hemorrhage.

Keywords

Streptococcus pneumoniae - serotype - meningoencephalitis - Down syndrome

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Referenzen

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