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Published on: February 23, 2014
Atypical case presentations of Streptococcus pneumoniae from level 1 trauma centre in India -A case series
Aishwarya Govindaswamy1, Sushma Sagar2, Vivek Trikha3
1Department of Microbiology, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India.
Abstract:
Streptococcus pneumoniae is a rare cause of appendicitis, skin soft tissue, and bloodstream infections. The clinical significance of its isolation from samples of skin or soft tissues and pus from the appendix is poorly understood. Invasive pneumococcal disease (IPD) continues to be a problem in India, associated with a high case fatality rate despite treatment facilities available in the hospital settings. In the present study, we report three adult cases, one presented as acute appendicitis, the other had skin and soft tissue infection, and third presented with bloodstream infection caused by Streptococcus pneumoniae from our level 1 trauma center. The patients with acute appendicitis and soft tissue infection recovered when treated with appropriate antimicrobial therapy, however, the one with pneumococcal sepsis could not be revived.
Insights
Streptococcus pneumoniae rarely causes appendicitis and skin infections. This study highlights its serious impact in invasive pneumococcal disease (IPD), with one sepsis case proving fatal despite treatment.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Streptococcus pneumoniae is an uncommon cause of appendicitis, skin, and soft tissue infections.
- Invasive pneumococcal disease (IPD) presents a significant public health challenge in India, marked by high mortality rates.
- The clinical relevance of pneumococcal isolates from appendix pus and skin/soft tissue samples requires further elucidation.
Observation:
- This study details three adult cases of infections caused by Streptococcus pneumoniae at a Level 1 trauma center.
- Cases included acute appendicitis, skin and soft tissue infection, and bloodstream infection (pneumococcal sepsis).
Findings:
- Patients with appendicitis and soft tissue infections due to Streptococcus pneumoniae showed recovery with appropriate antimicrobial treatment.
- The patient with pneumococcal sepsis did not survive, underscoring the severity of invasive pneumococcal disease.
Implications:
- These cases underscore the importance of considering Streptococcus pneumoniae in the differential diagnosis of appendicitis and soft tissue infections.
- The high fatality rate in the pneumococcal sepsis case emphasizes the need for prompt diagnosis and aggressive management of IPD.
- Further research is warranted to understand the pathogenesis and optimize treatment strategies for non-typical pneumococcal infections.
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