Vaccine-type pneumococcal pneumonia. Occurrence after vaccination in an asplenic patient.

Abstract

SPLENECTOMIZED individuals are at high risk for development of life-threatening pneumococcal bacteremia, 1 and pneumococcal polysaccharide vaccine has been recommended for these patients. While splenectomized patients have shown normal antibody responses to the polyvalent vaccines, 2,3 defined 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. Report of a Case 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