Renal Transplantation Unit, Nephrology Service, Hospital Clinic Barcelona, Spain.
Infectious Disease Service, Hospital Clínic Barcelona, Spain; Vall d'Hebron Institute for Research (VHIR), Barcelona, Spain.
Med Clin (Barc). 2020 Dec 11;155(11):502-505. doi: 10.1016/j.medcli.2020.05.022. Epub 2020 Jun 5.
In the context of the COVID-19 pandemic the risk of misdiagnosis of other causes of respiratory infection is likely. In this work we aim to describe the clinical characteristics, treatment and outcome of pneumococcal infection in COVID-19 patients.
Every COVID-19 patient presenting with concomitant pneumococcal pneumonia during March 2020 in a tertiary teaching Hospital In Barcelona, Spain.
Five patients with PCR confirmed COVID19 or clinical and radiological suspicion were diagnosed of pneumococcal infection. In all cases chest X-ray were abnormal, with unilateral or bilateral infiltrates. Procalcitonin showed to be not sensitive enough to detect pneumococcal infection. Antibiotherapy was promptly started in all five cases with subsequent satisfactory evolution.
International guidelines do not include the universal screening for bacterial co-infection. Radiological pattern of COVID-19 can be indistinguishable from that of pneumococcus pneumonia and frequency of co-infection is not well stablished, therefore clinicians should be aware of the possible SARS-CoV-2-pneumococcus association to avoid misdiagnosis and delay antibiotic therapy.
在 COVID-19 大流行的背景下，其他呼吸道感染病因的误诊风险可能增加。在这项工作中，我们旨在描述 COVID-19 患者中肺炎球菌感染的临床特征、治疗和转归。
2020 年 3 月，在西班牙巴塞罗那的一家三级教学医院，每例伴有同时性肺炎球菌肺炎的 COVID-19 患者。
5 例 PCR 确诊 COVID19 或临床和影像学怀疑的患者被诊断为肺炎球菌感染。所有病例的胸部 X 线均异常，存在单侧或双侧浸润。降钙素原的检测对肺炎球菌感染的敏感性不够。所有 5 例患者均及时开始抗生素治疗，随后病情均有好转。
国际指南不包括对细菌合并感染的普遍筛查。COVID-19 的影像学模式可能与肺炎球菌肺炎无法区分，合并感染的频率也尚未确定，因此临床医生应意识到 SARS-CoV-2-肺炎球菌可能存在关联，以避免误诊和延迟抗生素治疗。
