Occult bacteremia as a manifestation of invasive pneumococcal infection
Kh. S. Khaertynov,
V. A. Anokhin,
S. V. Khaliullina,
P. N. Emelyanova,
T. G. Stepanova,
А. Kh. Bulatova https://doi.org/10.21508/1027-4065-2020-65-5-215-218
Abstract
Objective. To describe a case of occult bacteremia caused by Streptococcus pneumoniae.
Results. A 1 year and 1 month old child was diagnosed with pneumococcal infection without a focus of infection. After examination of the child, the doctors excluded foci of infection characteristics of pneumococcal infection, and the discharge of St. pneumoniae from the blood enabled to diagnose occult bacteremia. Despite bacteremia and signs of systemic inflammatory response, the absence of severe clinical manifestations and signs of multiple organ failure gave grounds to exclude sepsis.
Conclusion. This case demonstrates that bacteriological blood test in children with fever and without a focus of infection with pronounced inflammatory changes in the blood has important diagnostic value and helps to prescribe effective specific antibacterial therapy.
About the Authors
Kh. S. Khaertynov
Kazan State Medical University
Russian Federation
Russian Federation
V. A. Anokhin
Kazan State Medical University
Russian Federation
Russian Federation
S. V. Khaliullina
Kazan State Medical University
Russian Federation
Russian Federation
P. N. Emelyanova
Agaphonov Republican Clinical Infectious Diseases Hospital
Russian Federation
Russian Federation
Kazan
T. G. Stepanova
Agaphonov Republican Clinical Infectious Diseases Hospital
Russian Federation
Russian Federation
Kazan
А. Kh. Bulatova
Kazan State Medical University
Russian Federation
Russian Federation
References
1. Filho E.M., de Carvalho W.B. Current management of occult bacteremia in infants. J Pediatr (Rio J) 2015; 91(6): S61—S66. DOI: 10.1016/j.jped.2015.06.004
2. Arora R., Mahajan P. Evaluation of child with fever without source: review of literature and update. Pediatr Clin North Am 2013; 60: 1049-1062. DOI: 10.1016/j.pcl.2013.06.009
3. Baraff L.J, Bass J.W., Fleisher G.R., Klein J.O., McCracken G.H., Powell K.R. et al. Practice Guideline for the Management of Infants and Children 0 to 36 Months of Age With Fever Without Source. Ann Emerg Med 1993; 22(7): 1198— 1210. DOI: 10.1016/s0196-0644(05)80991-6
4. Jaffe D.M., Tanz, R.R., Davis A.T., Henretig F., Fleisher G. Antibiotic administration to treat possible occult bacteremia in febrile children. N Engl J Med 1987; 317: 1175-1180.
5. Bass J.W., Steele R.W., Wittler R.R., Weisse M.E., Bell V, Heisser A.H. et al. Antimicrobial treatment of occult bacteremia: a multi-center cooperative study. Pediatr Infect Dis J 1993; 12: 466-473.
6. Gomez B., Hernandez-Bou S., Garcia-Garcia J.J., Mintegi S. Bacteremia in previously healthy children in emergency departments: clinical and microbiological characteristics and outcome. Eur J Clin Microbiol Infect Dis 2015; 34: 453-460. DOI: 10.1007/s10096-014-2247-z
7. Baranov A.A., Tatochenko V.K. Clinical guidelines. Pediatrics (Pneumonia in children). M.: GEOTAR-Media, 2005; 28. (in Russ.)
8. Van de Beek D., Cabellos C., Dzupova O., Esposito S, Klein M., Kloek A.T. et al. ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clinical Microbiology and Infection. 2016; 22(S3): S37-S62. DOI: 10.1016/j.cmi.2016.01.007
9. Brouwer M.C., Tunkel A.R., van de Beek D. Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis. Clin Microbiol Rev 2010; 23(3): 467-492. DOI:10.1128/CMR.00070-09
10. Arditi M., Mason E.O.Jr., Bradley J.S., Tan T.Q., Bar-son W.J., Schutze G.E. et al. Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use. Pediatrics 1998; 102(5): 1087-1097. DOI: 10.1542/peds.102.5.1087
11. Polk D.B., Steele R.W. Bacterial meningitis presenting with normal cerebrospinal fluid. Pediatr Infect Dis J 1987; 6: 1040-1042.
12. Domingo P., Mancebo J., Blanch L., Coll P., Net A., Nol-la J. Bacterial meningitis with “normal” cerebrospinal fluid in adults: A report on five cases. Scand J Infect Dis 1990; 22: 115-116.
13. Hase R., Hosokawa N., Yaegashi M., Muranaka K. Bacterial meningitis in the absence of cerebrospinal fluid pleocytosis: A case report and review of the literature. Can J Infect Dis Med Microbiol 2014; 25(5): 249-251. DOI: 10.1155/2014/568169
14. Lukes S.A., Posner J.B., Nielsen S., Armstrong D. Bacterial infections of the CNS in neutropenic patients. Neurol 1984; 34: 269-275.
15. Lekmanov А.и., Mironov P.I., Rud-nov V.А., Kulabukhov V.V. Modern definitions and principles of intensive care for sepsis in children. \festnik anesteziologii i reanimatologii (Bulletin of Anesthesiology and Intensive Care) 2018; 15(4): 61-69. (in Russ.)
16. Knapp K.M., Schutze G.E. The Approach to Treatment of Invasive Pneumococcal Disease in the 1990s. J Ark Med Soc 1997;94(6):263-266.
17. American academy of pediatrics. Therapy for Children With Invasive Pneumococcal Infections. American Academy of Pediatrics Committee on Infectious Diseases. Pediatrics 1997; 99(2): 289-299.
Review
For citations:
Khaertynov Kh.S., Anokhin V.A., Khaliullina S.V., Emelyanova P.N., Stepanova T.G., Bulatova А.Kh. Occult bacteremia as a manifestation of invasive pneumococcal infection. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2020;65(5):215-218. (In Russ.) https://doi.org/10.21508/1027-4065-2020-65-5-215-218
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