Bacteremia-Induced Cholestatic Jaundice as a Major Manifestation of Pneumococcal Infection in a Healthy Toddler

AbstractThe development of pneumococcal conjugate vaccines has substantially decreased the incidence of invasive pneumococcal diseases. However, the incidence of bacteremia due to nonvaccine serotypes has increased. Therefore, it is important to recognize the symptoms and complications of pneumococcal infection to expedite diagnosis. Herein, we report the case of a 22-month-old patient diagnosed with pneumococcal bacteremia who presented with cholestatic jaundice and fever without any other signs of systemic sepsis. The patient's condition improved soon after antibacterial therapy. Other causes of jaundice were possibly ruled out based on the screening test for viral hepatitis, and there were no abnormal findings on abdominal ultrasonography. Therefore, the present case suggests that cholestatic jaundice could be a manifestation of pneumococcal bacteremia.

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Potential serotype coverage of three pneumococcal conjugate vaccines against invasive pneumococcal infection in Italian children

Vaccine ◽

10.1016/j.vaccine.2011.12.008 ◽

2012 ◽

Vol 30 (16) ◽

pp. 2701-2705 ◽

Cited By ~ 9

Author(s):

Chiara Azzari ◽

Maria Moriondo ◽

Martina Cortimiglia ◽

Claudia Valleriani ◽

Clementina Canessa ◽

...

Keyword(s):

Pneumococcal Infection ◽

Conjugate Vaccines ◽

Pneumococcal Conjugate Vaccines ◽

Italian Children ◽

Invasive Pneumococcal Infection

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Rates of Pneumococcal Disease in Adults With Chronic Medical Conditions

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu024 ◽

2014 ◽

Vol 1 (1) ◽

Cited By ~ 99

Author(s):

Kimberly M. Shea ◽

John Edelsberg ◽

Derek Weycker ◽

Raymond A. Farkouh ◽

David R. Strutton ◽

...

Keyword(s):

At Risk ◽

Pneumococcal Disease ◽

Pneumococcal Pneumonia ◽

Pneumococcal Infection ◽

Chronic Medical Conditions ◽

Medical Conditions ◽

Conjugate Vaccines ◽

Pneumococcal Conjugate Vaccines ◽

Increased Risk ◽

Immunocompetent Adults

Abstract Background. Although it is widely accepted that adults with immunocompromising conditions are at greatly increased risk of pneumococcal infection, the extent of risk among immunocompetent adults with chronic medical conditions is less certain, particularly in the current era of universal vaccination of children with pneumococcal conjugate vaccines. Methods. We conducted a retrospective cohort study using data from 3 healthcare claims repositories (2006–2010) to compare rates of pneumococcal disease in immunocompetent adults with chronic medical conditions (“at-risk”) and immunocompromised adults (“high-risk”), with rates in adults without these conditions (“healthy”). Risk profiles and episodes of pneumococcal disease—all-cause pneumonia, pneumococcal pneumonia, and invasive pneumococcal disease (IPD)—were ascertained from diagnosis, procedure, and drug codes. Results. Rates of all-cause pneumonia among at-risk persons aged 18–49 years, 50–64 years, and ≥65 years were 3.2 (95% confidence interval [CI], 3.1–3.2), 3.1 (95% CI, 3.1–3.1), and 3.0 (95% CI, 3.0–3.0) times the rates in age-matched healthy counterparts, respectively. We idetified rheumatoid arthritis, systemic lupus erythematosus, Crohn's disease, and neuromuscular or seizure disorders as additional at-risk conditions for pneumococcal disease. Among persons with at-risk conditions, the rate of all-cause pneumonia substantially increased with the accumulation of concurrent at-risk conditions (risk stacking): among persons 18–49 years, rate ratios increased from 2.5 (95% CI, 2.5–2.5) in those with 1 at-risk condition to 6.2 (95% CI, 6.1–6.3) in those with 2 conditions, and to 15.6 (95% CI, 15.3–16.0) in those with ≥3 conditions. Findings for pneumococcal pneumonia and IPD were similar. Conclusions. Despite widespread use of pneumococcal conjugate vaccines, rates of pneumonia and IPD remain disproportionately high in adults with at-risk conditions, including those with conditions not currently included in the Advisory Committee on Immunization Practices’ guidelines for prevention and those with multiple at-risk conditions.

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Should Pneumococcal Vaccines Eliminate Nasopharyngeal Colonization?

mBio ◽

10.1128/mbio.00545-16 ◽

2016 ◽

Vol 7 (3) ◽

Cited By ~ 10

Author(s):

Larry S. McDaniel ◽

Edwin Swiatlo

Keyword(s):

Streptococcus Pneumoniae ◽

Pneumococcal Infection ◽

Invasive Disease ◽

Pneumococcal Vaccines ◽

Human Pathogen ◽

Next Generation ◽

Nasopharyngeal Colonization ◽

Conjugate Vaccines ◽

Pneumococcal Conjugate Vaccines

ABSTRACT Streptococcus pneumoniae remains an important human pathogen. For more than 100 years, there have been vaccine efforts to prevent pneumococcal infection. The pneumococcal conjugate vaccines have significantly reduced invasive disease. However, these vaccines have changed pneumococcal ecology within the human nasopharynx. We suggest that elimination of the pneumococcus from the human nasopharynx can have consequences that should be considered as the next generation of pneumococcal vaccines is developed.

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