Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2019; 7(24): 4277-4284
Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4277
Pneumococcal infection transmission between family members with congenital asplenia: A case report
Jumpei Shibata, Kazuhiro Hiramatsu, Tsuneaki Kenzaka, Takehito Kato
Jumpei Shibata, Kazuhiro Hiramatsu, Takehito Kato, Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Aichi 4418570, Toyohashi, Japan
Tsuneaki Kenzaka, Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Hyogo 6520032, Kobe, Japan
Author contributions: Shibata J was responsible for the clinical management of the patient, drafting and editing of the manuscript; Hiramatsu K participated in critical revision of the manuscript for intellectual content; Kenzaka T is a major contributor in revise the manuscript and select data; Kato T is a contributor in checking whether the final manuscripts were adequate for submitting; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients’ family.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jumpei Shibata, MD, Doctor, Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Aichi 4418570, Toyohashi, Japan. shibata-junpei@toyohashi-mh.jp
Telephone: +81-532-336111 Fax: +81-532-336177
Received: September 28, 2019
Peer-review started: September 28, 2019
First decision: November 11, 2019
Revised: November 22, 2019
Accepted: November 27, 2019
Article in press: November 27, 2019
Published online: December 26, 2019
Abstract
BACKGROUND

Asplenia, the lack of a spleen, can be congenital and increases susceptibility to severe infections caused by encapsulated bacteria, such as Streptococcus pneumoniae (S. pneumoniae). We report two cases of severe pneumococcal infection in two asplenic family members living in the same household.

CASE SUMMARY

Patient 1, a 38-year-old man with a history of congenital hepatitis B infection and hypospadias, was brought to our emergency department with complaints of cyanosis, cough, and edema of his limbs. He was clinically diagnosed as hyposplenic with overwhelming pneumococcal sepsis. He was admitted to the intensive care unit and was administered antibiotics and catecholaminergic therapy but died 2 h after admission. Patient 2, a 63-year-old woman with a history of type 2 diabetes, was brought to our emergency department one month after admission of Patient 1. She was diagnosed as asplenic with overwhelming pneumococcal sepsis. History-taking revealed that she was the mother of Patient 1 and the two had lived in the same household. She was admitted to the intensive care unit and was rapidly provided antibiotics and catecholaminergic intervention but died one day after admission.

CONCLUSION

Pneumococcal bacteremia caused by virulent S. pneumoniae may be transmitted within households. All residents of households where individuals with pneumococcal bacteremia are living should be educated about the risk of transmissibility. Family members of patients with congenital asplenia/hyposplenia, all family members should be examined to assess their splenic function.

Keywords: Streptococcus pneumoniae, Pneumococcal infection, Asplenia, Hyposplenia, Isolated congenital asplenia, Septic shock, Case report

Core tip: We present two cases of severe pneumococcal infection transmitted between family members with congenital asplenia. Streptococcus pneumoniae infection may be transmitted within a household, so all household members should be warned when there is an infection in the house. In addition, asplenia/hyposplenia is sometimes congenital, so family members should be screened for these conditions.