FIVE-FOLD INCREASE IN PEDIATRIC PARAPNEUMONIC EMPYEMA SINCE INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINE

FIVE-FOLD INCREASE IN PEDIATRIC PARAPNEUMONIC EMPYEMA SINCE INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINE.

Brief Reports

Pediatric Infectious Disease Journal. 27(11):1030-1032, November 2008.
Hendrickson, Debra J. MD; Blumberg, Dean A. MD; Joad, Jesse P. MD; Jhawar, Sanjay MD; McDonald, Ruth J. MD

Abstract:
A retrospective review of medical records for all pediatric parapneumonic empyema (PPE) patients admitted to our hospital from 1996 to 2006 revealed that PPE increased 5-fold in the post-heptavalent pneumococcal conjugate vaccine (PCV7) period (2001-2005) relative to the pre-PCV7 period (1996-2000), from 13 cases to 65. Most of this increase was associated with culture-negative empyema, which accounted for 61% of all post-2000 cases; 19% was culture-positive pneumococcal empyema. Our analysis indicates that non-PCV7 serotypes became more prevalent at our institution after introduction of the vaccine.

Advertisements

Herpes Zoster with Skin Lesions and Meningitis Caused by 2 Different Genotypes of the Oka Varicella-Zoster Virus Vaccine

Herpes Zoster with Skin Lesions and Meningitis Caused by 2 Different Genotypes of the Oka Varicella-Zoster Virus Vaccine

 

A previously healthy boy who had received varicella vaccine developed herpes zoster with meningitis. The vaccine strain recovered from scabs of 3 skin lesions had the wild-type allele at position 108111, a vaccine marker never previously associated with vaccine-associated adverse events. The vaccine strain from cerebrospinal fluid also contained mutations never previously observed at vaccine-associated single nucleotide polymorphisms that would alter amino acid sequences in ORF54 and ORF59. The presence of distinct strains in skin lesions and cerebrospinal fluid indicate that >1 variant strain may reactivate to cause herpes zoster.

The Journal of Infectious Diseases 2008;198:1444–1447