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Simultaneous Streptococcus pneumoniae empyema in fraternal twins
Alvaro E Galvis1, Sana Kamboj1,2, Craig Nakamura1,2
1University of Nevada, School of Medicine, Department of Pediatrics, Lied Clinic, 1524 Pinto Lane, Second Floor, 89106 Las Vegas, NV, United States.
Idcases
|May 23, 2017
Summary
This case study highlights penicillin-resistant Streptococcus pneumoniae pneumonia in fraternal twins. The near-identical illness progression in siblings suggests potential subtle genetic factors or undetected anatomical abnormalities.
Area of Science:
- Infectious Diseases
- Pediatrics
- Genetics
Background:
- Community-acquired pneumonia is frequently caused by Streptococcus pneumoniae.
- Multi-drug resistance in Streptococcus pneumoniae has increased significantly over the past two decades.
- Pneumococcal pneumonia is a common childhood illness, but rarely reported in simultaneous or near-simultaneous cases in fraternal twins.
Purpose of the Study:
- To report a unique case of bilateral, concurrent penicillin-resistant Streptococcus pneumoniae pneumonia in African-American fraternal twins.
- To investigate potential underlying factors contributing to the near-identical presentation and progression of pneumococcal pneumonia in the twins.
- To explore the implications of this case for understanding the pathophysiology of simultaneous infections in genetically distinct siblings.
Main Methods:
- Clinical presentation and diagnostic workup of 16-month-old fraternal twins presenting with pneumonia symptoms.
- Bacteriological cultures to identify the causative agent and antibiotic susceptibility testing.
- Tomography scans to assess for anatomical abnormalities.
- Literature review of reported cases of pneumococcal pneumonia in twins.
Main Results:
- Both fraternal twins presented with similar pneumonia symptoms and were diagnosed with penicillin-resistant Streptococcus pneumoniae infection.
- Tomography scans did not reveal any shared anatomical abnormalities that could explain the synchronized illness.
- A comprehensive literature search found no prior reports of simultaneous or non-simultaneous pneumococcal pneumonia in fraternal twins.
Conclusions:
- This case represents the first reported instance of fraternal twins experiencing simultaneous penicillin-resistant Streptococcus pneumoniae pneumonia.
- The near-identical illness progression suggests potential, yet undetected, anatomical abnormalities or subtle genetic factors influencing susceptibility and disease course in the siblings.
- Further investigation is warranted to elucidate the pathophysiology behind such concordant infections in genetically related individuals.
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