Pediatria pre prax S3/2010

Pneumokoková pneumónia s bakteriémiou u dieťaťa očkovaného Prevenarom (PCV7) – kazuistika

MUDr. Pavol Šimurka, PhD.

3-ročné dieťa s anamnézou opakovaného užívania antibiotík (vrátene azitromycínu) 4 mesiace pred prijatím, hospitalizované pre pneumóniu so septickým priebehom. Pozitívna hemokultúra (pneumokok), polyrezistencia na antibiotiká, vyžaduje zmenu antibiotickej liečby. Klinický priebeh zdĺhavý, neskôr plná úprava nálezu. Dieťa bolo kompletne očkované 7-valentnou konjugovanou pneumokokovou vakcínou (Prevenar – PCV7). Sérotypizáciou bol potvrdený sérotyp 19A, ktorý nie je v 7-valentnej ani 10-valentnej vakcíne. Zastúpený je v 13-valentnej vakcíne Prevenar 13.

Kľúčové slová: pneumokoková pneumónia s bakteriémiou, konjugovaná 7-valentná pneumokoková vakcína, azitromycín, polyrezistentný pneumokok, sérotyp 19A.

Pneumococcal pneumonia with bacteraemia in a child vaccinated with Prevenar (PCV7) – case report

Child aged 3, with an anamnesis of repeated antibiotic treatment (including azithromycin) for 4 months before being admitted to hospital. The patient has been hospitalised for pneumonia with septic course. The hemo-culture was positive (pneumococcus), poly-resistance to antibiotics, necessitating a change of the antibiotics treatment. The clinical course was long, later followed by a complete recovery. The child has been fully vaccinated with a 7-valent conjugate pneumococcal vaccine (Prevenar – PCV7). The serotype 19A was confirmed by serotypisation – which is present neither in the 7-valent nor in the 10-valent vaccine. This is included in the 13-valent vaccine Prevenar 13.

Keywords: pneumococcal pneumonia with bacteraemia, 7-valent conjugate pneumococcal vaccine, azithromycin, poly-resistant pneumococcus, serotype 19A.