Department of Internal Medicine, Hyogo Prefectural Kaibara Hospital, 5208-1, Kaibara, Kaibara-cho, Tanba, Hyogo, 669-3395, Japan.
Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5, Arata-cho, Hyogo-ku, Kobe, Hyogo, 652-0032, Japan.
BMC Infect Dis. 2018 Dec 17;18(1):666. doi: 10.1186/s12879-018-3588-5.
Pneumococci normally reside in the nasopharynx, and when individuals are in close contact with each other such as in a community or a family setting, it is transmitted from carriers and sometimes results in pneumonia.
Case 1: The patient was a 55-year-old woman who visited the hospital complaining of fever and headache. Lumbar pain occurred on hospital day 2, and purulent spondylitis was diagnosed using lumbar MRI. Blood culture results were positive for pneumococcus. Case 2: The patient was a 60-year-old male, and the husband of the woman in the Case 1. Fever and lumbar pain occurred on the same day similar to Case 1. Inpatient treatment was provided for pneumococcal bacteremia. Although no abnormalities were observed on the lumbar MRI scan taken on hospital day 2, purulent spondylitis was diagnosed by an MRI taken on hospital day 9. Both patients received appropriate antimicrobial treatment. When bacterial strain analysis was performed on samples from Cases 1 and 2, we noted that the capsule serotype was 12F, the drug sensitivity was similar, and the sequence typing matched completely, indicating that the causative bacteria for both cases were identical.
Pneumococcal bacteremia and purulent spondylitis can occur in different members of a family simultaneously. Pneumococcal infection can transmit between two close family members; hence, whenever a close family member of an individual who has already been infected with pneumococcal infection, develops fever, the possibility of transmission must be considered.
肺炎球菌通常寄居在鼻咽部,当个体彼此密切接触时,例如在社区或家庭环境中,它会从携带者传播,并有时导致肺炎。
病例 1:患者为 55 岁女性,因发热、头痛就诊。入院第 2 天出现腰痛,腰椎 MRI 诊断为化脓性脊椎炎。血培养结果为肺炎球菌阳性。病例 2:患者为 60 岁男性,为病例 1 中女性的丈夫。与病例 1 同日出现发热、腰痛。因肺炎球菌菌血症入院治疗。虽然入院第 2 天腰椎 MRI 扫描未见异常,但入院第 9 天 MRI 诊断为化脓性脊椎炎。两位患者均接受了适当的抗菌治疗。对病例 1 和 2 的样本进行细菌株分析时,我们注意到荚膜血清型为 12F,药敏性相似,序列分型完全匹配,表明两例的病原体相同。
肺炎球菌菌血症和化脓性脊椎炎可同时发生在家庭中的不同成员身上。肺炎球菌感染可在两个密切接触的家庭成员之间传播;因此,当个体的密切家庭成员已经感染肺炎球菌感染时,应考虑传播的可能性。