Pneumococcal infection transmission between family members with congenital asplenia: A case report  

作　　者：Jumpei Shibata Kazuhiro Hiramatsu Tuneaki Kenzaka Takehito Kato 

机构地区：[1]Department of General Surgery,Toyohashi Municipal Hospital,50 Aza Hachiken Nishi,Aotake-Cho,Aichi 4418570,Toyohashi,Japan [2]Division of Community Medicine and Career Development,Kobe University Graduate School of Medicine,Hyogo 6520032,Kobe,Japan

出　　处：《World Journal of Clinical Cases》2019年第24期4277-4284,共8页世界临床病例杂志

摘　　要：BACKGROUND Asplenia,the lack of a spleen,can be congenital and increases susceptibility to severe infections caused by encapsulated bacteria,such as Streptococcus pneumoniae(S.pneumoniae).We report two cases of severe pneumococcal infection in two asplenic family members living in the same household.CASE SUMMARY Patient 1,a 38-year-old man with a history of congenital hepatitis B infection and hypospadias,was brought to our emergency department with complaints of cyanosis,cough,and edema of his limbs.He was clinically diagnosed as hyposplenic with overwhelming pneumococcal sepsis.He was admitted to the intensive care unit and was administered antibiotics and catecholaminergic therapy but died 2 h after admission.Patient 2,a 63-year-old woman with a history of type 2 diabetes,was brought to our emergency department one month after admission of Patient 1.She was diagnosed as asplenic with overwhelming pneumococcal sepsis.History-taking revealed that she was the mother of Patient 1 and the two had lived in the same household.She was admitted to the intensive care unit and was rapidly provided antibiotics and catecholaminergic intervention but died one day after admission.CONCLUSION Pneumococcal bacteremia caused by virulent S.pneumoniae may be transmitted within households.All residents of households where individuals with pneumococcal bacteremia are living should be educated about the risk of transmissibility.Family members of patients with congenital asplenia/hyposplenia,all family members should be examined to assess their splenic function.BACKGROUND Asplenia, the lack of a spleen, can be congenital and increases susceptibility to severe infections caused by encapsulated bacteria, such as Streptococcus pneumoniae(S. pneumoniae). We report two cases of severe pneumococcal infection in two asplenic family members living in the same household.CASE SUMMARY Patient 1, a 38-year-old man with a history of congenital hepatitis B infection and hypospadias, was brought to our emergency department with complaints of cyanosis, cough, and edema of his limbs. He was clinically diagnosed as hyposplenic with overwhelming pneumococcal sepsis. He was admitted to the intensive care unit and was administered antibiotics and catecholaminergic therapy but died 2 h after admission. Patient 2, a 63-year-old woman with a history of type 2 diabetes, was brought to our emergency department one month after admission of Patient 1. She was diagnosed as asplenic with overwhelming pneumococcal sepsis. History-taking revealed that she was the mother of Patient 1 and the two had lived in the same household. She was admitted to the intensive care unit and was rapidly provided antibiotics and catecholaminergic intervention but died one day after admission.CONCLUSION Pneumococcal bacteremia caused by virulent S. pneumoniae may be transmitted within households. All residents of households where individuals with pneumococcal bacteremia are living should be educated about the risk of transmissibility. Family members of patients with congenital asplenia/hyposplenia, all family members should be examined to assess their splenic function.

关 键 词：Streptococcus pneumoniae Pneumococcal infection ASPLENIA Hyposplenia Isolated congenital asplenia Septic shock Case report 

分 类 号：R563.1[医药卫生—呼吸系统] R698.2[医药卫生—内科学]