A case report of septic shock syndrome caused by S. pneumoniae in an immunocompromised patient despite of vaccination.
A case report of septic shock syndrome caused by S. pneumoniae in an immunocompromised patient despite of vaccination.
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DOI：
10.1186/s12879-017-2481-y
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发表时间：
2017-06-22
影响因子：
3.7
通讯作者：
Thalhammer F
中科院分区：
文献类型：
--
作者：
Singer J;Testori C;Schellongowski P;Handisurya A;Müller C;Reitter EM;Graninger W;Knöbl P;Staudinger T;Winkler S;Thalhammer F
我们报告了一例由肺炎链球菌引起的败血性休克综合征，患者因自身免疫性淋巴增殖综合征（ALPS）而接受了脾切除术，其特点是免疫调节功能障碍。尽管该患者在脾切除后接种了结合多糖疫苗，但他仍然容易受到肺炎链球菌感染，因为分离的血清型（24F）是一种长期被认为是无致病性的血清型，目前批准的任何疫苗（无论是结合多糖疫苗还是非结合多糖疫苗）都没有涵盖该血清型。该病例表明，由于存在不同血清型，患者接种疫苗所针对的细菌感染也必须被视为鉴别诊断。尽管近年来疫苗的开发已将肺炎链球菌的覆盖范围从 7 种血清型扩大到 23 种血清型，但仍然需要能够针对所谓的“非致病性”菌株提供更广泛保护的新型疫苗，特别是对于高危人群。
We report a case of septic shock syndrome caused by Streptococcus pneumoniae in a patient who had undergone splenectomy due to an autoimmune lymphoproliferative syndrome (ALPS), which is characterized as a dysfunction of immunoregulation. Although the patient was vaccinated with a conjugated polysaccharide vaccine after the splenectomy, he was still susceptible to S. pneumoniae infection, because the isolated serovar (24F), a serovar long thought to be apathogenic, is not covered by any vaccine currently approved, neither a conjugated nor an unconjugated polysaccharide one. This case demonstrates that, due to presence of different serovars, also infections with bacteria against which patients are vaccinated have to be considered as differential diagnosis. Although vaccine development has extended the coverage of S. pneumoniae from 7 to 23 serovars within recent years, there is still demand for novel vaccines which can provide broader protection also against so-thought “apathogenic” strains, especially for groups at high risk.