Diawara Idrissa, Zerouali Khalid, Elmdaghri Naima, Abid Abderrahman
Laboratoire de Microbiologie, Faculté de Médecine et de Pharmacie, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco.
Service de Microbiologie, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco.
BMC Pediatr. 2017 Apr 27;17(1):114. doi: 10.1186/s12887-017-0872-2.
Simple parapneumonic effusion is a pleural effusion associated with lung infection (i.e., pneumonia). Streptococcus pneumoniae remains the most common pathogen causing parapneumonic effusions. In Morocco, the pneumococcal conjugate vaccine 13-valent (PCV13) was introduced in the national immunization program in October 2010 in 2 + 1 schedule for prevention of pneumococcal disease, and replaced by the PCV10 in July 2012 in the same schedule. We report a case of parapneumonic pleural effusions caused by S. pneumoniae serotype 19A in a child immunized with 3 doses of PCV13.
This is a 2.5 years old previously healthy Moroccan female, fully vaccinated by PCV13 and immunocompetent, admitted to a private medical clinic with a six months history of persistent asthma. On arrival (7 February 2015), she was febrile to 40.3 °C with a brutal flu syndrome, chills, dry cough and serous rhinitis, for which she received symptomatic treatment. A biological assessment was done that confirmed the clinical diagnosis of flu. Seven days after, she presented a progressive deterioration of its general condition and the onset of severe abdominal pain. She was hospitalized and a second biological assessment, computed tomography scans and chest radiography were done that confirmed a diagnosis of a pneumococcal parapneumonia with abscess of the left lower lobe with encysted empyema. Microbiological analysis of the pleural fluid showed a S. pneumoniae serotype 19A with susceptibility intermediate to penicillin. The patient was treated by antibiotics including amoxicillin, cefixime ceftriaxone and vancomycin.
We reported a case of parapneumonic pleural effusions caused by a vaccine serotype pneumococcal 19A occurring in an immunocompetent child immunized with 3 doses of PCV13.
单纯性类肺炎性胸腔积液是一种与肺部感染（即肺炎）相关的胸腔积液。肺炎链球菌仍然是引起类肺炎性胸腔积液最常见的病原体。在摩洛哥，2010年10月13价肺炎球菌结合疫苗（PCV13）以2 + 1程序被纳入国家免疫规划以预防肺炎球菌疾病，并于2012年7月在相同程序中被PCV10取代。我们报告了1例在接种3剂PCV13的儿童中由19A血清型肺炎链球菌引起的类肺炎性胸腔积液病例。
这是一名2.5岁、此前健康的摩洛哥女性，已通过PCV13完成全程接种且免疫功能正常，因持续哮喘6个月病史入住一家私立诊所。入院时（2015年2月7日），她发热至40.3℃，伴有急性流感综合征、寒战、干咳和浆液性鼻炎，为此接受了对症治疗。进行了生物学评估，证实了流感的临床诊断。7天后，她的一般状况逐渐恶化，并开始出现严重腹痛。她被收治入院，并进行了第二次生物学评估、计算机断层扫描和胸部X线检查，证实诊断为左下叶肺炎球菌性类肺炎伴脓肿形成及包裹性脓胸。胸腔积液的微生物学分析显示为19A血清型肺炎链球菌，对青霉素敏感性为中度。患者接受了包括阿莫西林、头孢克肟、头孢曲松和万古霉素在内的抗生素治疗。
我们报告了一例在接种3剂PCV13的免疫功能正常儿童中由疫苗血清型肺炎球菌19A引起的类肺炎性胸腔积液病例。
