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Invasive Streptococcus pneumoniae infection causing hemolytic uremic syndrome in children: Two recent cases

Otto G Vanderkooi1, James D Kellner, Andrew W Wade

  • 1Alberta Children's Hospital, Calgary, Alberta.

The Canadian Journal of Infectious Diseases = Journal Canadien Des Maladies Infectieuses
|December 27, 2007
PubMed
Abstract

Insights

Streptococcus pneumoniae can cause hemolytic uremic syndrome (HUS) through a unique mechanism distinct from Shiga toxin. Prompt diagnosis and treatment are crucial for patient recovery, as demonstrated in two pediatric cases.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Hematology

Background:

  • Streptococcus pneumoniae is an infrequent cause of hemolytic uremic syndrome (HUS).
  • The pathophysiology of S. pneumoniae-associated HUS differs significantly from Shiga toxin-induced HUS.
  • Understanding rare causes of HUS is critical for accurate diagnosis and management.

Observation:

  • Two pediatric cases of S. pneumoniae-related HUS presented with pneumonia and empyema.
  • Both patients required temporary dialysis due to renal involvement.
  • Neither case showed evidence of Shiga toxin-associated disease.

Findings:

  • Pulsed-field gel electrophoresis (PFGE) and Shiga toxin assays were used to characterize the S. pneumoniae strains.
  • Penicillin-susceptible S. pneumoniae isolates, serotypes 3 and 14, were identified.
  • Distinct PFGE patterns were observed between the two strains, suggesting independent occurrences.

Implications:

  • S. pneumoniae remains an uncommon yet significant etiological agent of HUS.
  • Diagnosis of S. pneumoniae-related HUS may not necessitate a renal biopsy.
  • This highlights the importance of considering bacterial infections in HUS etiology.
Keywords:
Hemolytic uremic syndromeStreptococcus pneumoniae

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