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Case Reports
Pneumococcal vaccine failure in an HIV-infected patient with fatal pneumococcal sepsis and HCV-related cirrhosis.
- M Begemann and M Policar.
- Department of Medicine, Elmhurst Hospital, New York, NY, USA.
- Mt. Sinai J. Med. 2001 Nov 1; 68 (6): 396-9.
AbstractPneumoccocal vaccination of HIV-positive individuals is recommended to prevent pneumococcal infection. We present a case of a 44-year-old HIV-infected male who came to the emergency room with bacterial pneumonia and sepsis. The patient also had a history of HBV and HCV infection. He expired in the emergency room and blood cultures were positive for Streptococcus pneumoniae. The autopsy confirmed the clinical diagnosis and, in addition, hepatitis C-related cirrhosis and splenic abnormalities. The patient had no history of opportunistic infections. His CD4 count 3 months prior to coming to the emergency room was 216 cells/microL with a viral load of 1,270 copies/mL. The patient had received Pneumovax two years before his death. The organism isolated from blood cultures was Streptococcus pneumoniae isotype 3, a strain included in Pneumovax. This is a case of pneumococcal vaccine failure with a fatal outcome in a person with an HIV infection and hepatitis C-related liver cirrhosis.
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