Bacterial meningitis due to streptococcus pneumoniae in a 7-month-old girl who received three doses of 13-valent pneumococcal conjugate vaccine

Abstract

In Japan, pneumococcal vaccine has been routinely administered since 2010 to prevent invasive pneu-mococcal diseases such as Streptococcus pneumoniae meningitis. We describe a case of pneumococcal meningitis in a 7-month-old girl who had received three doses of 13-valent pneumococcal conjugate vaccine. Brain magnetic resonance imaging showed infarcts in the right frontal region, and she was treated with antibiotics, intravenous immunoglobulin, dexamethasone, and edaravone. On day 27, an enhanced brain CT scan showed improvement of abnormal findings in the frontal region, except for slight atrophy. The S. pneumoniae serotype was 12F, which is not included in the 13-valent pneumococ-cal conjugate vaccine. A future vaccine is expected to use cross-reactivity to target common antigens.