Invasive pneumococcal disease with multiple septic emboli and septic arthritis in an immunocompetent patient

Authors

  • Vitor Rogério Palmeiro de Sousa Mendes
  • Pedro Manuel Sarmento Rodrigues Póvoa

DOI:

https://doi.org/10.34119/bjhrv8n3-245

Keywords:

Streptococcus pneumoniae, pneumonia, bacteriaemia, septic emboli, septic arthritis

Abstract

We report a case of an immunocompetent male, on the early 70s, with a background of cardiovascular disease who presented with cough with hemoptoic sputum and progressive fatigue. He was diagnosed with invasive Streptococcus pneumoniae infection manifesting as pneumonia and bacteraemia, complicated by multiple septic emboli (cerebral, cerebellar, splenic, renal) and septic arthritis. Despite broad-spectrum antibiotic therapy and organ support, the patient deteriorated and died within a week. This case highlights the potential for severe and rare complications of invasive pneumococcal infection, even in patients without overt immunodeficiency.

References

BURGOS, J. et al. Impact of the emergence of non-vaccine pneumococcal serotypes on the clinical presentation and outcome of adults with invasive pneumococcal pneumonia. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, v. 19, n. 4, p. 385–391, abr. 2013, DOI: 10.1111/j.1469-0691.2012.03895.x

FEIKIN, D. R. et al. Serotype-specific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites. PLoS medicine, v. 10, n. 9, p. e1001517, 24 set. 2013, DOI: 10.1371/journal.pmed.1001517.

HICKS, L. A. et al. Incidence of pneumococcal disease due to non-pneumococcal conjugate vaccine (PCV7) serotypes in the United States during the era of widespread PCV7 vaccination, 1998-2004. The journal of infectious diseases, v. 196, n. 9, p. 1346–1354, 1 nov. 2007, DOI: 10.1086/521626.

MOORE, M. R. et al. Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the USA: analysis of multisite, population-based surveillance. The Lancet infectious diseases, v. 15, n. 3, p. 301–309, mar. 2015, DOI: 10.1016/S1473-3099(14)71081-3.

MUSHER, D. M. Infections caused by Streptococcus pneumoniae: clinical spectrum, pathogenesis, immunity, and treatment. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, v. 14, n. 4, p. 801–807, abr. 1992, DOI: 10.1093/clinids/14.4.801.

MUSHER, D. M. et al. The association between pneumococcal pneumonia and acute cardiac events. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, v. 45, n. 2, p. 158–165, 15 jul. 2007.

MUSHER, D. M.; THORNER, A. R. Community-acquired pneumonia. The New England journal of medicine, v. 371, n. 17, p. 1619–1628, 23 out. 2014, DOI: 10.1056/NEJMra1312885.

NELSON, A. L. et al. Capsule enhances pneumococcal colonization by limiting mucus-mediated clearance. Infection and immunity, v. 75, n. 1, p. 83–90, jan. 2007, DOI: 10.1128/IAI.01475-06.

PLETZ, M. W. et al. The burden of pneumococcal pneumonia - experience of the German competence network CAPNETZ. Pneumologie (Stuttgart, Germany), v. 66, n. 8, p. 470–475, ago. 2012, DOI: 10.1055/s-0032-1310103.

SOUSA, A. et al. Clinical and microbiological characteristics of unusual manifestations of invasive pneumococcal disease. Enfermedades infecciosas y microbiologia clinica (English ed ), v. 36, n. 5, p. 284–289, maio 2018, DOI: 10.1016/j.eimc.2017.05.003.

TAYLOR, S. N.; SANDERS, C. V. Unusual manifestations of invasive pneumococcal infection. The American journal of medicine, v. 107, n. 1, p. 12–27, jul. 1999, DOI: 10.1016/s0002-9343(99)00103-5.

VAN DER POLL, T.; OPAL, S. M. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet, v. 374, n. 9700, p. 1543–1556, 31 out. 2009, DOI: 10.1016/S0140-6736(09)61114-4.

WEISER, J. N.; FERREIRA, D. M.; PATON, J. C. Streptococcus pneumoniae: transmission, colonization and invasion. Nature reviews. Microbiology, v. 16, n. 6, p. 355–367, jun. 2018, DOI: 10.1038/s41579-018-0001-8

Published

06/12/2025

How to Cite

MENDES, V. R. P. de S.; PÓVOA, P. M. S. R. Invasive pneumococcal disease with multiple septic emboli and septic arthritis in an immunocompetent patient. Brazilian Journal of Health Review, [S. l.], v. 8, n. 3, p. e80365, 2025. DOI: 10.34119/bjhrv8n3-245. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/80365. Acesso em: 16 oct. 2026.

Issue

Section

Original Papers