Unusual presentation of Streptococcus pneumoniae in human immunodeficiency virus infection

Area of Science:

• Infectious Diseases
• Pediatric Oncology
• Immunology

Background:

• Streptococcus pneumoniae is a common pathogen causing respiratory tract, inner ear, and meningeal infections.
• Infections at unusual sites are infrequently documented in Human Immunodeficiency Virus (HIV)-seropositive individuals.
• Co-infection with B cell lymphoma in HIV-positive pediatric patients presents complex clinical challenges.

Observation:

• A case of a child with Human Immunodeficiency Virus (HIV) infection and B cell lymphoma is presented.
• The child developed a subcutaneous abscess behind the ear (post-auricular).
• No other primary focus of Streptococcus pneumoniae infection was identified.

Findings:

• The post-auricular subcutaneous abscess was caused by Streptococcus pneumoniae.
• This presentation is unusual due to the absence of preceding bacteremia or respiratory infection.
• The specific clinical scenario of pneumococcal abscess in an immunocompromised child with lymphoma is rare.

Implications:

• This case underscores the potential for Streptococcus pneumoniae to cause invasive disease at unusual sites in immunocompromised children.
• It highlights the importance of considering atypical presentations in HIV-infected patients, especially those with hematologic malignancies.
• Further research may be warranted to understand the specific risk factors and management strategies for such rare infections.