Invasive pneumococcal disease (IPD) is defined as the recovery of an isolate of S. pneumoniae from a normally sterile site, such as blood, cerebrospinal fluid (CSF), pleural fluid, joint aspirate, pericardial fluid, or peritoneal fluid [1]. Splenic abscesses are rare in the pediatric population [2]. Early recognition and intervention are critical due to the high mortality rate associated with delayed diagnosis [3]. A literature review revealed no case reports of splenic abscesses due to invasive pneumococcal disease (IPD). Purpura fulminans is a rare complication of IPD. We report a case of IPD confirmed by blood culture and serotyping in a 15 month old African American female whose clinical coursewas complicated by splenic abscesses and …show more content…
Laboratory investigations revealed a pH of 7.1, PCO2 of 35mmHg, PO2 of 52mmHg, HCO3 of 11mg/dl, prothrombin time of 37.8 seconds, international normalized ratio (INR) of 3.8, activated partial prothrombin time of 101.4 seconds, total leukocyte count of 1900/mm3 with 10% banded neutrophils and 25% segmented neutrophils, hemoglobin of 10.8g/dl and platelet count of 67,000/mm3. Lumbar puncture was performed and revealed a white blood cell count of 1 per mm3, red blood cell count of 3 per mm3, glucose of 108mg/dl and protein 83mg/dl. Blood, urine and cerebrospinal fluid (CSF) cultures were sent and she was started on broad spectrum antibiotics with vancomycin and ceftriaxone.
She was admitted to the pediatric intensive care unit (PICU) for management of septic shock, disseminated intravascular coagulopathy and multiple organ dysfunction syndrome. Blood culture grew Streptococcus pneumoniae that was sensitive to penicillin and ceftriaxone with a minimum inhibitory concentration (MIC) of less than 0.03 mcg/ml. She was initially hypotensive despite being placed on vasoactive medications for treatment of refractory shock. During her PICU course, it was she was noted to develop dry gangrene of the distal phalanges on her upper (Figure 1A) and lower extremities (Figure 1B), which were consistent with purpura fulminans. She remained febrile after resolution of septic shock. A computerized tomography (CT) scan of abdomen with contrast revealed 3 rim-enhancing
Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows
She continues to take the following medications: GABAPENTIN 400MG , ASPIRIN 81MG, Oxaprozin 600mg and
She also seemed to have a respiratory infection and possibly urinary infection and was treated with IV fluids and IV ceftriaxone. I have not received directives from the family being a nephew to do otherwise. She recovered significantly with the IV fluids and further with the antibiotics and now seems back to baseline if not better for the absence of these medications. She actually said today that she felt well, which was very unusual. She said she slept well last night and had a good breakfast. All are things that perhaps six weeks ago would have led to long complaints. There have been small wounds on her
On November 3, 2014, client, JL, presented to the emergency department. The mother of the client reported increased “fussiness” and refusal to bear weight on right leg that started over the weekend. Client has history of Sickle Cell Disease which called for a routine complete blood count with differential to be conducted. Results were as follows: WBC-
A. Etiology – Most of the time sepsis is caused by “hospital-acquired gram-negative bacilli or gram-positive cocci and often occur in immunocompromised patients and patients with chronic and debilitating diseases” (Maggio). Sepsis “may be associated with the introduction of microbes into the blood stream directly via” invasive hospital instruments (Cuna).
B.R. is a 10-year-old previously healthy female that presented with persistent cough after a failed outpatient therapy for pneumonia. Two weeks ago she developed a sore throat and intermittent fever. She was seen by her PCP, where her strep test tested negative; therefore, she was diagnosed with a viral upper respiratory infection. She later developed significant left upper quadrant abdominal pain and was in bed for two days. She was seen again by her PCP, where she was diagnosed with constipation. She continued to have pain and fever; therefore, her parents took her to Kaweah Delta Hospital where and ultrasound was done. The ultrasound, monospot test, and strep test performed at Kaweah Delta were all negative. They then performed a CT and
Community acquired pneumonia (CAP) is and has been a major health problem here in the U.S. This disease mostly affects young children and the elderly 65. Streptococcus pneumoniae is the most common bacteria causing pneumonia, this bacterium has over 90 different stereotypes and is extremely hard to pin point the different mutating strains. Pneumonia is contracted from inhalation of droplets; any one coughing or sneezing around your area and carrying the virus can pass it along to you fairly easy. Pneumonia is an upper respiratory infection that causes the lungs to be inflamed and fill the alveoli (air sacs) with fluids causing lack of oxygen to the red blood cells. The most common test for S. pneumoniae is the optichin sensitivity with an optichin
Outcome: Non-invasive pneumococcal infection. Episodes are pneumonia (R81), acute bronchitis/bronchiolitis(R78), influenza(R80), sinusitis (R75) and otitis media (H71) from primary care visit.
Streptococcus pneumoniae is found worldwide. The common host is the human body, in which it often does not cause disease but at other times it can cause diseses in particular, pneumonia. It also causes otitis media, bacteremia, meningitis, peritonitis, and sinusitis. The route by which this organism is spread is from human to human in the form of aerosol droplets. When inside the host the organism’s primary site of pneumococcal colonization is the nasopharynx. From this site it can aspire to the lungs, eventually spread to the blood and traverse the blood-brain barrier to the meninges, once inside the blood it can cause infections throughout the body. Symptoms of the disease include sudden
Pneumonias most common form is the Streptococcus pneumoniae but when it is caused by another bacterium it is called atypical pneumonia or walking pneumonia which usually causes a less severe form of the disease (hajiliadas, 2014). However pneumonia caused by the typical bacterium Streptococcus pneumoniae can be very severe and even life threatening. Symptoms of pneumonia can range in type and severity of the disease but usually someone who has or is developing the illness will feel fatigued, be running a fever, and will develop a cough that will most likely produce phlegm. In some cases patients have developed fluid being released into the plural cavity and in mire severe cases that fluid can become infected. The diagnosis for this illness is very straight forward and usually can be diagnosed by taking a pulse oximetry test and/or a sputum test. However, if the illness is in advanced stages and life threating X-rays of the chest can be performed in order to determine the severity and progression of the illness. This disease is easily treatable by antibiotics but for more severe cases antibiotics usually do not help.
Pneumococcal Disease is a deadly, if not treated in time or correctly, infection that is caused by a strand of bacteria called Streptococcus Pneumoniae. It is capable of causing pneumonia in the lungs, bacteremia in the bloodstream, meningitis, encephalitis, and middle ear and sinus infections. It travels from person to person through breathing in tiny respiratory droplets from an infected person. Pneumococcal disease kills about 5000 people in the U.S yearly with more of them being under the age of 2 or over the age of 65. These two age groups are targeted the most because it’s when your immune system starts to build up but still not as effective or when your immune system starts to become ineffective
Pneumococcal lobar pneumonia is a disease that generally infects the entire lungs. According to Kadioglu (290), bacteria that are known as streptococcus pneumoniae, also referred to as pneumococcus, cause the infection. The bacteria are a coccus that is located in pairs or small chains. Pneumococcal lobar pneumonia encompasses a large section of a lobe or the whole lobe of the lung. Moreover, pneumococcal lobar pneumonia has reduced its effects due to quick response to the treatment methods, although this disease is still a large menace in the developed nations. In the developing nations, pneumococcal lobar pneumonia is a major cause of mortality. Similarly, this illness mostly affects young people and middle-aged adults; it rarely infects babies and old individuals. In addition, pneumococcal lobar pneumonia has been commonly analyzed to be affecting men more than women. People who drink alcohol and use tobacco products are also highly susceptible to lobar pneumonia.
The clinical manifestations of pneumonia will be different according to the causative organism and the patient’s underlying conditions and/or comorbidities (Smeltzer, et al). Some of the manifestations are
Pneumonia is an inflammation or infection of the lungs most commonly caused by a bacteria or virus. Pneumonia can also be caused by inhaling vomit or other foreign substances. In all cases, the lungs' air sacs fill with pus , mucous, and other liquids and cannot function properly. This means oxygen cannot reach the blood and the cells of the body.