Article in Japanese

Pneumococcal meningitis developing in two children after head and neck surgery

Hiroyuki MIYAZAKI^1）, Yuhei TANAKA^1）, Saho SHIMA^1）, Atsushi MIYAKE^1,2）, Kazuaki TATARA^1）, Kiyohito OKUMIYA^1）, Kenji GOTOH^1,2）

Invasive pneumococcal disease (IPD) has been reported every year, although the pneumococcal conjugate vaccine is widespread as routine vaccination in Japan. Herein, we report two cases of pneumococcal meningitis as a complication of head and neck surgery. Case 1 involves a 6-year-old boy who developed pneumococcal meningitis, caused by Streptococcus pneumoniae serotype 15B, the day after he underwent adenoidectomy and tympanostomy tube insertion. Case 2 involves a 7-year-old girl who developed pneumococcal meningitis, caused by S. pneumoniae serotype 15A, five months after receiving cochlear implantation for congenital hearing loss. Both the patients had been vaccinated with the 13-valent pneumococcal conjugate vaccine (PCV13), but the causative pneumococcal serotypes were not included in PCV13. In recent years, IPD caused by pneumococcal serotypes not contained in PCV13 has increased worldwide. Most cases diagnosed with bacterial meningitis are infants and children below the age of five years；however, the underlying disease may develop in children over five years of age. Bacterial meningitis after head and neck surgery is rare. Nevertheless, for cases with suspected bacterial meningitis (showing symptoms like fever, headache, and vomiting) after head and neck surgery, a careful approach and prompt therapy are required.

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1）Department of Pediatrics and Child Health, Kurume University School of Medicine

2） Department of Infection Control and Prevention, Kurume University School of
Medicine

Key words	Streptococcus pneumoniae, bacterial meningitis, 13-valent pneumococcal conjugate vaccine (PCV13), head and neck surgery, postoperative complications
Received	June 5, 2021
Accepted	October 4, 2021

33 (4)：373─380,2021