Empyema due to Streptococcus Pneumoniae Serotype 9V in a Child Immunized with 13-Valent Conjugated Pneumococcal Vaccine

Year 2017, Volume: 34 Issue: 1, 74 - 77, 01.01.2017

Murat Sütçü Hacer Aktürk Fatih Karagözlü Ayper Somer Nezahat Gürler Nuran Salman

Abstract

Background: Clinical vaccine failure is the occurence of the specific vaccine-preventable disease in an appropriately and fully vaccinated person after enough time has elapsed for protection against the antigens of the vaccine to develop. Fully immunized cases with pneumoccal vaccine may sometimes develop a complicated pneumonia with empyema caused by a vaccine serotype. Case Report: A 2 year-old male patient was admitted with the complaints of fever. On the basis of findings and laboratory results, the patient was diagnosed as having empyema. He was successfully treated with parenteral antibiotics and chest tube drainage. The pleural fluid culture and hemoculture of the patient yielded penicillin-susceptible pneumococci and the isolate was identified as serotype 9V. The patient had been vaccinated with a 13-valent pneumococcal conjugate vaccine according to the Turkish national immunization schedule at 2, 4, 6 and 12 months of age. His medical history and basic immunological profile were inconsistent with a primary immunodeficiency. Conclusion: The failure of the PCV13 vaccine may results in a complicated pneumonia with empyema. It is important to investigate serotypes of pneumococci in these cases to determine other possible vaccine failures due to PCV13 and to study the underlying mechanisms.

Keywords

Empyema, Streptococcus pneumoniae serotype 9V, 13-valent pneumococcal conjugate vaccine

References

• 1. Bekri H, Cohen R, Varon E, Madhi F, Gire R, Guillot F, et al. Streptococcus pneumoniae serotypes involved in children with pleural empyemas in France. Arch Pediatr 2007;14:239-43.
• 2. Grijalva CG, Nuorti JP, Zhu Y, Griffin MR. Increasing incidence of empyema complicating childhood community-acquired pneumonia in the United States. Clin Infect Dis 2010;50:805.
• 3. Byington CL, Hulten KG, Ampofo K, Sheng X, Pavia AT, Blaschke AJ, et al. Molecular epidemiology of pediatric pneumococcal empyema from 2001 to 2007 in Utah. J Clin Microbiol 2010;48:520-5.
• 4. Ceyhan M, Ozsurekci Y, Gürler N, Ozkan S, Sensoy G, Belet N, et al. Distribution of Streptococcus pneumoniae serotypes that cause parapneumonic empyema in Turkey. Clin Vaccine Immunol 2013;20:972-6.
• 5. Fletcher M, Leeming J, Cartwright K, Finn A; South West of England Invasive Community Acquired Infection Study Group. Childhood empyema: limited potential impact of 7-valent pneumococcal conjugate vaccine. Pediatr Infect Dis J 2006;25:559-60.
• 6. Langley JM, Kellner JD, Solomon N, Robinson JL, Le Saux N, McDonald J, et al. Empyema associated with community-acquired pneumonia: a Pediatric Investigator’s Collaborative Network on Infections in Canada (PICNIC) study. BMC Infect Dis 2008;8:129.
• 7. Heininger U, Bachtiar NS, Bahri P, Dana A, Dodoo A, Gidudu J, et al. The concept of vaccination failure. Vaccine 2012;30:1265-8.
• 8. Antachopoulos C, Tsolia MN, Tzanakaki G, Xirogianni A, Dedousi O, Markou G, et al. Parapneumonic pleural effusions caused by Streptococcus pneumoniae serotype 3 in children immunized with 13-valent conjugated pneumococcal vaccine. Pediatr Infect Dis J 2014;33:81-3.
• 9. Madhi F, Godot C, Bidet P, Bahuaud M, Epaud R, Cohen R. Serotype 3 pneumococcal pleural empyema in an immunocompetent child after 13-valent pneumococcalconjugate vaccine. Pediatr Infect Dis J 2014;33:545-6.
• 10. Yeh SH, Gurtman A, Hurley DC, Block SL, Schwartz RH, Patterson S, et al. Immunogenicity and safety of 13-valent pneumococcal conjugate vaccine in infants and toddlers. Pediatrics 2010;126:e493- 505