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Diarrhea in Streptococcus pneumoniae bacteremia
Insights
Diarrhea with fever is a notable symptom in children with Streptococcus pneumoniae bacteremia, particularly those with sickle cell disease. Prompt medical attention is crucial, as this symptom can indicate a severe infection with higher mortality risks.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Streptococcus pneumoniae (S. pneumoniae) bacteremia poses a significant health risk in children.
- Sickle cell disease (SSD) is a known risk factor for severe pneumococcal infections.
Observation:
- Diarrhea with fever was observed in 9.3% of non-SSD children and 13% of SSD children with S. pneumoniae bacteremia.
- Two children with sickle cell disease and S. pneumoniae bacteremia who developed diarrhea shortly after admission died, highlighting a potential severity indicator.
Findings:
- The mortality rate for S. pneumoniae bacteremia without diarrhea in SSD patients was 12.5%.
- Only one non-SSD patient with diarrhea and S. pneumoniae bacteremia died, suggesting diarrhea might not be as severe an indicator in non-SSD cases.
- The seasonality and serotypes associated with diarrhea cases mirrored overall S. pneumoniae infection patterns.
Implications:
- Diarrhea with fever in children with S. pneumoniae bacteremia, especially those with sickle cell disease, warrants urgent clinical evaluation.
- Understanding the clinical presentation of S. pneumoniae bacteremia can aid in early diagnosis and management, potentially improving outcomes in vulnerable pediatric populations.
Abstract:
Diarrhea with fever was a significant complaint in 26 of 280 (9.3%) of non-SS children with S. pneumoniae bacteremia and four of 30 (13%) children with sickle syndromes and S. pneumoniae bacteremia. Two additional children with sickle-cell disease and S. pneumoniae bacteremia developed diarrhea within hours of hospital admission; four of the six died. The mortality rate among 24 additional SS patients with S. pneumoniae bacteremia without diarrhea was 12.5% (3/24). Only one of 26 non-SS patients with diarrhea and S. pneumoniae bacteremia died; shs was surgically asplenic and had fulminant 9-hour course. The seasonality of the diarrhea cases was similar to our overall experience, and the serotypes associated with the diarrhea cases were also representative of our overall experience. Although predominantly seen in infants, the oldest non-SS patient was 12 years, and the oldest SS patient was nine years.
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