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Invasive Infektion durch Streptococcus pneumoniae Serotyp 8 im Säuglingsalter

Invasive infection from Streptococcus pneumoniae serotype 8 in infancy

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Zusammenfassung

Hintergrund

Trotz des inzwischen erweiterten Spektrums der Pneumokokkenimpfung durch PCV13 (PCV: Pneumokokkenkonjugatvakzine) treten weiterhin invasive Pneumokokkenerkrankungen auf.

Fall

Wir berichten über einen 4 Monate alten, weiblichen Säugling, der 2 Tage vor der stationären Aufnahme hoch fieberte und zunehmend schlechter getrunken hatte.

Diagnose

Nach umfangreicher Diagnostik (Labor, Katheterurin- und Liquordiagnostik, Blutkultur, Katheterurinkultur, Rachenabstrich, Stuhl, Sonographie des Schädels) konnte in Zusammenschau aller Befunde die Diagnose einer invasiven Infektion durch Streptococcus pneumoniae Serotyp 8 (Meningitis, Sepsis) gestellt werden. Im Verlauf entwickelte sich komplizierend ein Hirnempyem.

Schlussfolgerung

Es wäre wünschenswert, weitere Serotypen in den Konjugatimpfstoffen zu implementieren, insbesondere jene, die für invasive Infektionen bekannt sind, wie in unserem Fall der Serotyp 8.

Abstract

Background

Despite the (now) extended spectrum of pneumococcal vaccination by PCV13 (PCV: pneumococcal conjugate vaccine), invasive pneumococcal disease continues to occur.

Case

We report on a 4-month-old female infant who was admitted to the pediatric hospital because of high fever and decreased oral intake of 2 day’s duration prior to admission.

Diagnosis

After extensive diagnostics (blood work, catheter urinalysis, cerebrospinal fluid analysis and culture, blood culture, catheter urine culture, throat swab, stool test, sonography of the brain), a diagnosis of invasive infection by Streptococcus pneumoniae serotype 8 (meningitis, sepsis) was made. The hospital course was complicated by cerebral empyema.

Conclusion

Consideration should be given to adding more serotypes to the conjugate vaccine, especially those which are known for invasive infections, as in our case, serotype 8.

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Abbreviations

BERA:

„Brainstem evoked response audiometry“, Hirnstammaudiometrie

cMRT:

Kranielle Magnetresonanztomographie

CrP:

C-reaktives Protein

DTaPIPVHepBHib:

6-Fach-Standardimpfung gegen Diphtherie, Tetanus, Pertussis, Poliomyelitis, Hepatitis B und Haemophilus influenzae (Serotyp B)

ESPED:

Erhebungseinheit seltener pädiatrischer Erkrankungen in Deutschland

Hb:

Hämoglobin

HIB:

Haemophilus influenzae (Serotyp B)

IPD:

„Invasive pneumococcal disease“

NRZ:

Nationales Referenzzentrum

PCV:

Pneumokokkenkonjugatvakzine

PCV13:

13-valenter Pneumokokkenkonjugatimpfstoff

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Thanos, M. Endmann und M. Rey geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Kinderklinik Klinikum Arnsberg, Stolte Ley 5, 59759, Arnsberg, Deutschland

    C. Thanos, M. Endmann & M. Rey

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  1. C. Thanos
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  2. M. Endmann
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  3. M. Rey
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Correspondence to C. Thanos.

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Thanos, C., Endmann, M. & Rey, M. Invasive Infektion durch Streptococcus pneumoniae Serotyp 8 im Säuglingsalter. Monatsschr Kinderheilkd 161, 1177–1179 (2013). https://doi.org/10.1007/s00112-013-3020-6

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  • DOI: https://doi.org/10.1007/s00112-013-3020-6

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