SEVERE SEPSIS AND MENINGOENCEPHALITIS WITH STREPTOCOCCUS PNEUMONIAE SEROTYPE 23 F IN A 5 – YEAR-OLD CHILD WITH TRANSETHMOIDAL MENINGOCELE AND CSF FISTULA

Drăgănescu Anca ¹, Bilasco Anuța ¹, Vișan Angelica ^1,2, Negulescu Cristina ¹, Vasile Magdalena ¹, Condria E. ¹, Dogaru Cornelia ¹, Slavu Diana ¹, Merisescu Mădălina ^1,2, Luminos Monica ^1,2
1 University of Medicine and Pharmacy „Carol Davila” Bucharest
² INBI “Prof. Dr. Matei Bals”, Bucharest

Abstract

Invasive pneumococcal disease (IPD), defined as isolation of Streptococcus pneumoniae from any normally sterile body site, continues to remain a major health problem, especially in the countries where pneumococcal vaccine was not introduced in the national immunization programs. Factors that increase the risk for IPD are young age, chronic conditions like humoral immunodeficiency, functional or anatomic asplenia, the presence of cochlear implants, CSF fistula and in child day care attendance. The most common serotypes involved in IPD were 14, 6B, 19F, and 23F in the pre vaccine era and 1, 19A, 3, 6A, and 7F since the introduction of PCV7. Methods & Results: We report the case of a 5-year-old girl admitted to our clinic with the diagnosis of Severe sepsis with Streptococcus pneumoniae serotype 23F, Severe Meningoencephalitis, with medical record of left trans-ethmoidal meningocele with CSF fistula. Conclusion: We present this case in order to highlight the importance of pneumococcal immunization in preventing serious infections with Streptococcus pneumoniae, especially in patients with increased risk factors for IPD and recurrent bacterial meningitis.