An Uncommon Site of Streptococcus pneumoniae Colonization Leading to Recurrent Pneumococcal Disease

Parham Sendi1,2, Eva Maria Moser Schaub3, Konstantinos Nirgianakis4

  • 1Departments of Infectious Diseases.

Insights

This case study shows a woman who experienced recurrent pneumococcal peritonitis, likely due to an intrauterine device. Vaccination with a pneumococcal conjugate vaccine led to increased antibody levels and prevented further infections.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Gynecology

Background:

  • Recurrent pneumococcal peritonitis is a rare but serious condition.
  • Intrauterine devices (IUDs) have been associated with an increased risk of pelvic inflammatory disease.
  • Vaginal colonization with Streptococcus pneumoniae can be a source of infection.

Purpose of the Study:

  • To describe a case of relapsing pneumococcal peritonitis.
  • To investigate the potential role of an intrauterine contraceptive device in recurrent infection.
  • To evaluate the efficacy of pneumococcal conjugate vaccine in preventing recurrence.

Main Methods:

  • Case report.
  • Clinical observation.
  • Serological testing for pneumococcal antibodies before and after vaccination.

Main Results:

  • The patient experienced recurrent episodes of pneumococcal peritonitis.
  • Vaginal colonization with Streptococcus pneumoniae was identified as the likely source.
  • Immunization with a pneumococcal conjugate vaccine resulted in elevated antibody titers.
  • The patient remained free of infection at a 2-year follow-up.

Conclusions:

  • An intrauterine contraceptive device can serve as a nidus for recurrent pneumococcal peritonitis in colonized women.
  • Pneumococcal conjugate vaccination may be an effective strategy for preventing recurrent infections in susceptible individuals.
  • This case highlights the importance of considering IUDs in the differential diagnosis of recurrent peritonitis.

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