Tuberc Respir Dis.  2014 Feb;76(2):80-83. 10.4046/trd.2014.76.2.80.

A Case on Streptococcal Pneumonia Associated with Leptomeningitis, Osteomyelitis and Epidural Abscess in a Patient with AIDS

• Jeon JW
• Yoon HJ
• Kim JS
• Ryu IH
• Choi JW
• Kim MG
• Na YM
• Yun HJ

• KMID: 1877345
• DOI: http://doi.org/10.4046/trd.2014.76.2.80

Abstract

Patients with acquired immunodeficiency syndrome (AIDS) are at higher risks of bacterial pneumonia than the general population, and the pathogen is the most commonly involved Streptococcus pneumoniae. We hereby report a case of pneumococcal pneumonia associated with leptomeningitis, osteomyelitis and epidural abscess in a patient with AIDS. He is being successfully treated with ampicillin/sulbactam and clindamycin. And because the pneumococcal infection is usually associated with morbidity and mortality rates in the setting of AIDS, we should consider for pneumococcal vaccinations among the AIDS populations.

Keyword

Acquired Immunodeficiency Syndrome; Streptococcus; Pneumonia; Meningitis; Osteomyelitis

MeSH Terms

Acquired Immunodeficiency Syndrome
Clindamycin
Epidural Abscess*
Humans
Meningitis
Mortality
Osteomyelitis*
Pneumococcal Infections
Pneumonia*
Pneumonia, Bacterial
Pneumonia, Pneumococcal
Streptococcus
Streptococcus pneumoniae
Vaccination
Clindamycin

Figure

• 

  Figure 1 Initial lung images. (A) Initial chest X-ray showed ground glass opacity and consolidation on both lung fields (especially the right lower lung field). (B) Initial contrast-enhanced chest computed tomography showed multiple irregular nodular infiltration in both lungs and patchy consolidation with ground glass opacity in the right middle and lower lungs.

• 

  Figure 2 Contrast-enhanced cervical spine magnetic resonance imaging. (A) Posterior epidural abscess; peripheral rim enhancing lesion at the posterior epidural space of cervical spine (C2-3) (arrow). (B) Osteomyelitis; mild enhancement in the clivus and scanned cervical spine (circle), early leptomeningitis; prominent leptomeningeal enhancement (arrow).

• 

  Figure 3 Follow-up of chest X-ray and cervical spine magnetic resonance. (A) Decreased ground glass opacity and consolidation on both lung fields were noted. (B) There is no abnormal signal nor contrast enhancement in C-spine and leptomeninges.

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