Invasive pneumococcal bacteremia in a 9-year-old boy caused by serotype 1: course, treatment and costs.
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Abstracto
Streptococcus pneumoniae is a leading cause of bacteremia, sepsis, meningitis, pneumonia, sinusitis, and acute otitis media in young children. Some serotypes are associated with particular disease syndromes, such as complicated pneumonias in children, or with higher rates of hospitalization in children and are consistently responsible for outbreaks in certain populations. In this report we describe a case of a nine-year-old boy who developed an abscess of pleura and invasive pneumococcal bacteremia. The boy was admitted to the hospital with abdominal pain and vomiting, accompanied by mild cough and fever. Chest X-ray revealed lower left lobe consolidation with pleural inflammation and chest CT showed extensive interstitial-alveolar changes in the left lung with atelectasis and pleural effusion causing a reduction in lung volume up to the fourth rib. From the 6(th) day of hospitalization on, suction drainage and intrapleural administration of alteplase were continued for 5 days. Intravenous antibiotics were administered for subsequent 32 days. The course of disease was complicated with labial herpes and acute adenoviral gastroenteritis. The costs of diagnosis (11.7%), pharmacotherapy (55.2%), hospitalization (30.7%) and additional procedures (2.4%) were about