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A case of fatal pneumococcal 19A meningoencephalitis despite administration of seven-valent pneumococcal conjugate vaccines

Korean Journal of Pediatrics 2009;52(4):508-511.
Published online April 15, 2009.
A case of fatal pneumococcal 19A meningoencephalitis despite administration of seven-valent pneumococcal conjugate vaccines
Ah Rum Heo, Jun Hwa Lee
Department of Pediatrics, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea
7가 페구균백신 접종에도 치명적인 폐구균 19A 수막염 1예
허아름, 이준화
성균관대학교 마산삼성병원 소아청소년과
Correspondence: 
Jun Hwa Lee, Email: ljh3643@skku.edu, ljh3643@hanmail.net
Abstract
Streptococcus pneumoniae is a major cause of serious invasive diseases in children, especially in young infants, but seven- valent pneumococcal conjugate vaccine (PCV7) is believed to prevent invasive pneumococcal pneumonia and meningitis in young children. However, recently, the incidence of non-PCV7 serotype has increased after PCV7 vaccination. A 14-month- old female patient presented at our emergency room with mental change and lethargy. Three days previously, she had developed fever and vomiting. After being admitted, she rapidly progressed to coma and brain death despite prompt and extensive supportive treatment. She expired 20 days after admission with a final diagnosis of pneumococcal 19A (non-PCV7 serotype) meningoencephalitis despite having received PCV7 (PrevenarⓇ) vaccinations on three occasions. The author reports this first fatality due to pneumococcal 19A meningoencephalitis in Korea and provides a brief review of the literature.
Key Words: Streptococcus Pneumonia Infections, Meningoencephalitis, Serotype 19A


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