Diplococcus pneumoniae Infections in Children With Sickle Cell Anemia

Abstract

In the last 4\m=1/3\years, 12 episodes of Diplococcus pneumoniae bacteremia or meningitis, or both, were observed in ten children with sickle cell anemia. Seven children were under 2 years of age; seven were boys, and three were girls. The infections were frequently fulminant and two patients died in spite of appropriate therapy. Seven patients required packed erythrocyte transfusions. The infections were caused by eight different serotypes of D pneumoniae. Patients with sickle cell anemia accounted for 7.3% of the children admitted with pneumococcal infections. Pneumococcal infections were present in 2.8% of children admitted with sickle cell anemia.

Pneumococcus-induced serotonin release from human platelets. Identification of the participating plasma/serum factor as immunoglobulin.

“…This contrasts with the ability of a normal IgG preparation to support release at concentrations as low as 0.05 mg/ml. DISCUSSION Septicemia with pneumococci and other bacteria, as well as infection with viruses and fungi, may be associated with thrombocytopenia with or without associated intravascular coagulation (1)(2)(3)(7)(8)(9). The mechanism for this thrombocytopenia, however, often is not clear.…”

“…Our studies indicate that the release is induced by pneumococcal antigen-antibody complexes and that antibodies capable of supporting this reaction are present in the great majority, if not all, of normal human plasma and sera. This reaction between pneumococcus, antibody, and platelets may play an important etiologic role in the thrombocytopenia and/or thrombo-hemorrhagic (7)(8)(9) complications accompanying infections with this microorganism.…”

A Family Study of IgG Subclasses in Sickle Cell Anemia

“…Sickle cell anemia is a chronic hemolytic anemia in which individuals have an increased susceptibility to infection (21). This has been attributed to defective opsonization (26) for pneumococcal polysaccharide and inability to activate the alternate pathway of complement (7).…”

Incidence of Major Infection in Sickle Cell Pediatric Patients at Qatif Central Hospital

“…Other investigations have emphasized the frequent occurrence of infections due to S. pneumoniae and Salmonella species [16][17][18]. We found that Salmonella species and S. pneumoniae were the cause in 20 of 30 cases (66%) of septicemia, and all were community-acquired infections.…”

“…During the two-year period, 20 Jumada I 1408 (January 9, 1989) to 20 Jumada I 1410 (December 18,1989), a total of 450 pediatric patients with sickle-cell anemia were admitted to the pediatric ward of Qatif Central Hospital. Thirty-nine patients had a major infection (septicemia, meningitis, or osteomyelitis), with an incidence of 8.6%.…”