Streptococcus pneumoniae: An Unusual Pathogen Seen In High Vaginal Swab

Abstract

Streptococcus pneumoniae are Gram positive lanceolate diplococci. In some individuals they are present as normal commensals of the nasopharynx. They cause pneumonia, otitis media, sinusitis, bronchitis and bacterial meningitis. Infection may be exogenous or endogenous in origin. S. pneumoniae however is not a part of the normal vaginal flora. We present a case of a 19 year old primigravida of 25 weeks amenorrhea, who presented with a history of non-productive cough since three days, abdominal pain since a day and spotting per vagina. She had a previous history of IgA nephropathy, and underwent dialysis and was on oral steroids. S. pneumoniae was isolated from the high vaginal swab culture. As it may predispose to neonatal sepsis, she was started on intravenous cefazolin. Due to severe pregnancy induced hypertension and premature rupture of membrane an elective caesarean section was done and a preterm low birth weight live female child was delivered. As the baby had an acute respiratory distress syndrome, feed intolerance and a raised C-Reactive protein, she was put on a ventilator and given antibiotics. This signifies that S. pneumoniae can be a resident vaginal flora especially in patients with predisposing factors. Patients with high risk of S.pneumoniae infection should be screened and vaccinated to reduce morbidity and mortality outcome for both mother and child.

Early neonatal respiratory distress revealing meningitis caused by Streptococcus pneumoniae serotype 17F: a case report

“…Incidence of vaginal colonization, often asymptomatic, is very low, varying between 0.03%–0.75% of cases 9 . Nevertheless, female genital tract infection may occur through four different possible mechanisms including infection via the vaginal primary resident flora from intra uterine device, the use of tampons, during orogenital sexual practices; via gastrointestinal tract; via lymphatics and via bloodstream 10 . In our case, the newborn mother presented only premature rupture of membranes at 34 weeks of gestational age.…”