Article in Japanese
A case of neonatal Streptococcus pneumoniae serotype 11A／E infection
Akiyoshi NARIAI, Toru UCHIMURA, Taichi KANETAKA
This study reports a boy presenting intrauterine Streptococcus pneumoniae infection with neonatal asphyxia followed by dyspnea. He was born transvaginally 15 hours after membrane rupture at 38 weeks' gestation. Colonies of α hemolysis were found to grow on the sheep-blood agar plates of the nasopharynx, skin and stool, one day after the initiation of ampicillin (ABPC). As Gram staining of the colonies revealed gram-positive diplococci, a diagnosis of neonatal S. pneumoniae infection was made. Then, a cerebrospinal fluid (CSF) was obtained, which revealed normal cell counts, a negative Gram staining and a negative latex agglutination test result, but a positive BinaxNOW® S. pneumoniae antigen test result. ABPC was withdrawn after two weeks with a good outcome. However, S. pneumoniae PCR, based on amplification of the lytA gene on the CSF sample, gave a negative result. Therfore, pneumococcal meningitis was ruled out.
An S. pneumoniae isolate was obtained from the nasopharynx of the patient's two-year old brother. The viginal culture from his mother was negative, but the BinaxNOW® S. pneumoniae antigen test for maternal urine samples gave a positive result. The S. pneumoniae isolates obtained from the boy and his brother revealed the same serotype, 11A／E, and sequence type, 99, susceptible to penicillin G.
Department of Pediatrics, Yokohama Minami Kyosai Hospital
|Received||April 4, 2013|
|Accepted||June 6, 2013|