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Unusual case of Pneumococcal Bacteremia and Meningitis
An unusual case of pneumococcal meningitis and bacteremia has appeared in NEJM.Dr Andres Carpio, at Albert Einstein Medical Center, Philadelphia, PA and colleagues have reported the case.
Courtesy NEJM
Streptococcus pneumoniae is an encapsulated organism that is removed by immunoglobin-mediated opsonization by phagocytes that reside primarily in the spleen. Asplenia leads to diminished antibody-mediated phagocytosis, increasing the vulnerability of the host to encapsulated pathogens. The patient was admitted to the intensive care unit and was treated with intravenous vancomycin, ceftriaxone, and immune globulin. Despite initial stabilization of the patient’s blood pressure, severe cognitive impairment developed, and he was transferred to hospice care.
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