The Turkish Journal of Pediatrics 2020 , Vol 62 , Num 6
A case of fulminant pneumococcus meningoencephalitis progressing with white matter involvement despite two doses of conjugated pneumococcus vaccine
Ebru Azapağası 1 ,Tanıl Kendirli 1 ,Gökçen Öz Tuncer 2 ,Serhan Özcan 1 ,Halil Özdemir 3 ,Suat Fitöz 4 ,Erdal İnce 3
1 Departments of Pediatric Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey
2 Departments of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Turkey
3 Departments of Pediatric Infection, Ankara University Faculty of Medicine, Ankara, Turkey
4 Departments of Pediatric Radiology, Ankara Unive Faculty of Medicine, Ankara, Turkey
DOI : 10.24953/turkjped.2020.06.018 Background. Streptococcus pneumonia is a cause of serious mortality and morbidity, especially among small children. However, currently, it causes lower rates of invasive infections due to successful vaccination programs

Case. We report an exceptional case of a 6-month-old child with meningoencephalitis caused by Streptococcus pneumonia despite the administration of two doses of pneumococcal conjugate vaccine (PCV). Meningitis progressed rapidly and led to widespread damage in parenchymal brain tissue with the emergence of fulminant meningoencephalitis. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed widespread brain lesions, suggesting extensive parenchymal injury.

Conclusion. Such diffuse white matter lesions among pediatric patients with Streptococcus pneumonia meningoencephalitis despite two doses of PCV have not been reported previously. Keywords : pneumococcal conjugate vaccine, meningoencephalitis, meningitis, streptococcus pneumoniae, serotype 19F

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