Overwhelming Pneumococcal Bacteremia Revealed by a Peripheral Blood Smear In a 74-year-old Healthy Woman

Nakamura, Hideta; Saitou, Manabu; Kinjo, Shunichi; Kaneshima, Hiroshi; Higa, Futoshi; Tateyama, Masao; Fujita, Jiro

doi:10.2169/internalmedicine.46.6032

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…Fulminant pneumococcal infection is considered to be a pneumococcal infection complicated with sepsis and purpura fulminans, which tends to occur in immunocompromised hosts such as patients who are asplenic or on immunosuppressants 1. However, fulminant pneumococcal infection can occur in non-immunocompromised individuals,3 4 as in the present case. The autopsy findings of this case showed multiple organ failure, DIC and sepsis.…”

Section: Discussionmentioning

confidence: 72%

Fulminant pneumococcal infection

et al. 2014

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Fulminant pneumococcal infection is a fatal pneumococcal infection that tends to occur in immunocompromised hosts, such as patients who are asplenic or on immunosuppressant therapy. We experienced a case of a 73-year-old Japanese man with a medical history of coronary stent implantation and catheter ablation for atrial flutter who presented with dyspnoea at rest. The patient was diagnosed with streptococcal pneumonia based on a urine antigen test and CT. Despite the use of effective antibiotics and systemic therapies, his clinical course was rapidly progressive and he died 18 h after admission. This case of fulminant pneumococcal infection is reported along with the autopsy findings.

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Section: Discussionmentioning

confidence: 72%

Fulminant pneumococcal infection

et al. 2014

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“…Functional asplenia in patients with SLE associated with overwhelming pneumococcal bacteremia was described (8). Moreover, overwhelming pneumococcal bacteremia was reported in a previous healthy patient (9).…”

Section: Discussionmentioning

confidence: 92%

Pneumococcal Vertebral Osteomyelitis and Psoas Abscess in a Patient with Systemic Lupus Erythematosus Disclosing Positivity of Pneumococcal Urinary Antigen Assay

et al. 2011

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A 53-year-old woman with systemic lupus erythematosus presented with a 3-day history of fever and coughing. Diagnosis of pneumococcal bronchitis was made based on symptoms and positivity of pneumococcal urinary antigen test. On day 3, severe low back pain acutely occurred. Pneumococcal vertebral osteomyelitis and psoas abscess was diagnosed 17 days later by yield of penicillin-susceptible S. pneumoniae strain in blood cultures and drainage fluid. Although pneumococcal urinary antigen test is a useful tool for the diagnosis of pneumococcal pneumonia, we should consider the possibility of pneumococcal infections other than pneumonia or overwhelming bacteremia in immunosuppressive patients when urinary antigen test is positive.

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“…Careful screening of PBS only frequently reveals intraleukocytic organisms. The criteria for diagnosing septicemia based on a PBS are as follows; cellular inclusion bodies are organisms, the organisms must be intracellular, and the cells containing organisms must be leukocytes and not nonhematopoietic cells [3]. If only extracellular microorganisms in PBS is observed, they have to be interpreted carefully because those could be contamination in vitro such as artifacts from slide glasses, anticoagulants, and staining fluid.…”

Section: Discussionmentioning

confidence: 99%

“…A microscopic examination of the peripheral blood smear (PBS) for detection of organisms has been reported to be a simple method that can be used to hasten the confirmation of septicemia thereby enabling doctors to immediately select more specific treatment. However, a PBS occasionally shows bacteria only in cases of overwhelming septicemia [1][2][3]. In Korea, report of diagnosis of bacteremia by the PBS is very rare [4].…”

Section: Introductionmentioning

confidence: 99%

Bacteremia Detected by a Peripheral Blood Smear in a Pediatric Surgical Patient with Thrombocytopenia

Kim

Lee

et al. 2010

Korean J Clin Microbiol

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Microscopic examination of peripheral blood smear (PBS) for detection of microorganisms is simple method that can be used for doctors to confirm the septicemia more swiftly and to select more specific therapy. But it is unusual to find microorganisms in PBS. We report a case of gram negative bacteremia diagnosed by PBS in a severe thrombocytopenic pediatric surgical patient. A 6-month and 2 week old baby with cyanosis was diagnosed congenital heart diseases such as transposition of great arteries, atrial septal defect, and patent ductus arteriosus. The infant underwent surgical operations and the postoperative platelet count progressively decreased in spite of transfusion of multiple platelet concentrates. We performed routine examination of a PBS for evaluation of severe thrombocytopenia. The PBS revealed severe thrombocytopenia, leukopenia with left shifted and some extracellular bacilli. Toxic granulations, toxic vacuoles and some bacilli were observed in the neutrophils. The bacilli were identified as Pseudomonas aeruginosa and Serratia marcescens in blood culture. To our knowledge, this is the second case of bacteremia diagnosed by PBS before the positive blood culture in Korea. We suggest that a PBS is useful for the rapid detection of organisms in cases of septicemia with severe thrombocytopenic pediatric surgical patient. (Korean J Clin Microbiol 2010;13:182-186)

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Overwhelming Pneumococcal Bacteremia Revealed by a Peripheral Blood Smear In a 74-year-old Healthy Woman

Abstract: Abstract

Cited by 8 publications

References 12 publications

Fulminant pneumococcal infection

Fulminant pneumococcal infection

Pneumococcal Vertebral Osteomyelitis and Psoas Abscess in a Patient with Systemic Lupus Erythematosus Disclosing Positivity of Pneumococcal Urinary Antigen Assay

Bacteremia Detected by a Peripheral Blood Smear in a Pediatric Surgical Patient with Thrombocytopenia

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