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Fatal overwhelming postsplenectomy infection caused by Streptococcus pneumoniae in mothers within 1 year after delivery: case report

  • Case Report
  • Published:
Journal of Infection and Chemotherapy

Abstract

Invasive pneumococcal disease (IPD) has a high mortality. Although preventive strategies including vaccination have been established for children, less attention has been devoted to pregnant and postnatal women and to mothers caring for their infants. As a significant number of women have either undergone splenectomy or are in a hyposplenic state and have not received adequate pneumococcal vaccinations, they can potentially develop overwhelming postsplenectomy infections. A 34-year-old woman with an 8-month-old baby, who underwent splenectomy at the age of 10 for benign pancreatic tumor, presented with fever and petechial eruption. Despite extensive treatment, she died 17 h after admission. A 40-year-old woman with a 11-month-old baby, who underwent splenectomy at 2 years of age for hemolytic anemia, was admitted for septic shock and disseminated intravascular coagulation. Despite extensive treatment, she died 2 h after admission. Blood cultures from both women were positive for Streptococcus pneumoniae and neither of them had been vaccinated against the bacterium. IPD rapidly progressed and developed to multiple organ dysfunction syndromes in mothers caring for their infants, particularly those who had undergone splenectomy or were in a hyposplenic state. Thus, routine pneumococcal vaccination is recommended for pregnant women. In addition, we suggest a thorough medical interview and checkup for splenectomy or hyposplenism in prenatal women.

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Acknowledgments

This study was funded and supported in part by a Health Labor Sciences Research Grant (H22-Shinko-Ippan-013).

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Division of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, 3256 Midori-cho, Tachikawa, Tokyo, 190-0014, Japan

    Toru Hifumi, Nobuaki Kiriu, Hiroshi Kato, Junichi Inoue & Yuichi Koido

  2. Department of Emergency Medicine and Critical Care Medicine, Keio University Hospital, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan

    Seitaro Fujishima & Junichi Sasaki

  3. Department of Bacteriology I, National Institute of Infectious Disease, Toyama 1-23-1, Shinjuku-ku, Tokyo, 162-8640, Japan

    Bin Chang

Authors
  1. Toru Hifumi
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  2. Seitaro Fujishima
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  3. Bin Chang
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  4. Junichi Sasaki
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  5. Nobuaki Kiriu
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  6. Hiroshi Kato
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  7. Junichi Inoue
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  8. Yuichi Koido
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Correspondence to Seitaro Fujishima.

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Hifumi, T., Fujishima, S., Chang, B. et al. Fatal overwhelming postsplenectomy infection caused by Streptococcus pneumoniae in mothers within 1 year after delivery: case report. J Infect Chemother 19, 1202–1205 (2013). https://doi.org/10.1007/s10156-013-0613-x

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  • DOI: https://doi.org/10.1007/s10156-013-0613-x

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