Invasive Pneumococcal Serotype 3 Disease Despite Pneumococcal Polysaccharide Vaccine-23

Abstract

Pneumococcal disease has a high global morbidity and mortality. We report a case of a 63-year old female with a history of vaccination with pneumococcal polysaccharide vaccine-23 (PPSV-23) who was transferred to a tertiary care facility with fever and seizures due to an unknown etiology. The diagnosis of invasive pneumococcal disease (IPD) was based the identification of Streptococcus pneumoniae in the blood (culture; serogroup 3) and cerebrospinal fluid (antigen), and the finding of purulence under pressure at craniotomy. The pneumococcal vaccine should provide protection from IPD. The findings reported here display that IPD can overcome immunity proffered by the pneumococcal vaccine especially in patients with multiple comorbidities. This patient represents those who are under-vaccinated despite national recommendations for pneumococcal vaccination