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Infected abdominal aortic aneurysm due to penicillin-, ceftriaxone-, and cefotaxime-resistant Streptococcus
W E Albrecht1, C J Papasian, D M Bamberger
1Department of Pathology, University of Missouri, Kansas City, USA.
Abstract:
The clinical course for a patient hospitalized with pneumonia and meningitis due to penicillin-, ceftriaxone-, and cefotaxime-resistant Streptococcus pneumoniae is described. The pneumonia and meningitis responded to antimicrobial therapy, but the patient died following rupture of an infected abdominal aortic aneurysm; gram-positive cocci resembling S. pneumoniae were detected within the aneurysm.
Insights
A patient with drug-resistant Streptococcus pneumoniae developed pneumonia and meningitis. Despite treatment, the patient died from a ruptured aortic aneurysm infected by the same bacteria.
Area of Science:
- Infectious Diseases
- Internal Medicine
- Critical Care Medicine
Background:
- Streptococcus pneumoniae is a common cause of bacterial pneumonia and meningitis.
- Antimicrobial resistance in S. pneumoniae poses a significant public health challenge.
- Infection of the abdominal aortic aneurysm is a rare but serious complication.
Observation:
- A patient presented with pneumonia and meningitis caused by S. pneumoniae resistant to penicillin, ceftriaxone, and cefotaxime.
- The patient's pneumonia and meningitis symptoms improved with appropriate antimicrobial therapy.
- The patient subsequently experienced a fatal rupture of an infected abdominal aortic aneurysm.
Findings:
- The causative agent of the pneumonia and meningitis was identified as multidrug-resistant Streptococcus pneumoniae.
- Gram-positive cocci, morphologically consistent with S. pneumoniae, were identified within the ruptured abdominal aortic aneurysm.
- This case highlights the potential for invasive S. pneumoniae infections to extend beyond typical sites.
Implications:
- Multidrug-resistant Streptococcus pneumoniae can cause severe invasive infections, including meningitis, pneumonia, and potentially endovascular infections.
- Prompt identification and appropriate antimicrobial therapy are crucial for managing S. pneumoniae infections.
- The findings underscore the importance of considering unusual presentations and complications in patients with resistant bacterial infections.