Vaccine-Type Pneumococcal Pneumonia

Abstract

SPLENECTOMIZED individuals are at high risk for development of life-threatening pneumococcal bacteremia,¹and pneumococcal polysaccharide vaccine has been recommended for these patients. While splenectomized patients have shown normal antibody responses to the polyvalent vaccines,^2,3defined by at least twofold rises in type-specific antibody level, protective levels of these antibodies are not known. This report describes a splenectomized patient in whom vaccine-type pneumococcal pneumonia developed 20 months after polyvalent pneumococcal vaccination. <h3>Report of a Case</h3> A 26-year-old woman was hospitalized on June 24,1978, with a 12-hour history of left pleuritic chest pain and dyspnea preceded by ten days of mild chest pain associated with a nonproductive cough and sore throat. Twenty-two years previously, she had had a splenectomy for familial nonimmune hemolytic anemia, which also affected her mother, all three of her natural siblings, one of three half-siblings, and three of her four nephews. Twenty-one and again 16 years