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Successful intervention for overwhelming postsplenectomy infection caused by non-vaccine pneumococcal serotype 23A
Yuichi Kojima1, Kazuna Ikeda2, Akihiro Matsumura2
1Division of Internal Medicine, Department of Internal Medicine, Chitose City Hospital, Hokkaido 066-8550, Japan.
Abstract:
The spleen plays an important role in the body's immune defense against invasive infections, particularly those caused by encapsulated bacteria. Encapsulated bacterial infection in asplenic patients is a medical emergency called overwhelming postsplenectomy infection (OPSI) and has a mortality rate of 50-70%. Here, we report the case of a 51-year-old Asian man who complained of emesis and diarrhea as primary symptoms. He rapidly progressed to coma and was eventually diagnosed with OPSI (pyogenic ventriculitis/spondylitis) caused by non-vaccine pneumococcal serotype 23A. Aggressive management, including empiric antibiotic therapy, a staircase approach for intracranial pressure-targeted therapy and laminectomy/laminoplasty, resulted in a good recovery. Our report highlights that non-vaccine pneumococcal serotypes can cause disease in vaccinated patients.
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