Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique Pneumococcus
A nonneutropenic patient with treated low-grade non-Hodgkin’s (Follicular) lymphoma and secondary hypogammaglobulinemia recovered from pneumococcal pneumonia and septicemia (serotype 7F; ST191) subsequent to influenza A H1N1 (2009). Both infections were potentially vaccine preventable. The patient t...
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| Format: | Article |
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Wiley
2012-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2012/386372 |
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| author | Clare Murphy Donald Inverarity Claire McGoldrick Lindsay Mitchell Pamela Paterson Louise Thom Giles Edwards |
| author_facet | Clare Murphy Donald Inverarity Claire McGoldrick Lindsay Mitchell Pamela Paterson Louise Thom Giles Edwards |
| author_sort | Clare Murphy |
| collection | DOAJ |
| description | A nonneutropenic patient with treated low-grade non-Hodgkin’s (Follicular) lymphoma and secondary hypogammaglobulinemia recovered from pneumococcal pneumonia and septicemia (serotype 7F; ST191) subsequent to influenza A H1N1 (2009). Both infections were potentially vaccine preventable. The patient then developed pneumococcal meningitis due to a serotype 35F pneumococcus with a unique Multilocus Sequence Type (ST7004) which was not vaccine preventable. Patient management was influenced by host predisposition to pneumococcal infection, antibiotic intolerance, and poor response to polysaccharide pneumococcal vaccine. Indirect immunofluorescence with anti-human immunoglobulin confirmed a poor or intermediate response to Pneumovax II. Prophylactic erythromycin was initiated, and immunoglobulin transfusions were also commenced as a preventive strategy. ST7004 is a single locus variant of ST1635 which has been associated with the serotype 35F capsule in England. The spi gene in ST7004, which differentiates it from ST1635, is the same as the spi gene present in ST191 which could have arisen from the first disease episode suggesting that horizontal gene transfer may have occurred between different populations of pneumococci present within the patient in an attempt to evade vaccination selection pressure. |
| format | Article |
| id | doaj-art-e9bc76b74efe4e66a265d8148cc12d06 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-e9bc76b74efe4e66a265d8148cc12d062025-02-03T01:22:22ZengWileyCase Reports in Hematology2090-65602090-65792012-01-01201210.1155/2012/386372386372Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique PneumococcusClare Murphy0Donald Inverarity1Claire McGoldrick2Lindsay Mitchell3Pamela Paterson4Louise Thom5Giles Edwards6Department of Infectious Disease, Monklands Hospital, Monkscourt Avenue, Airdrie ML6 0JS, UKDepartment of Medical Microbiology, Monklands Hospital, Airdrie ML6 0JS, UKDepartment of Infectious Disease, Monklands Hospital, Monkscourt Avenue, Airdrie ML6 0JS, UKDepartment of Clinical Haematology, Monklands Hospital, Airdrie ML6 0JS, UKDepartment of Clinical Haematology, Monklands Hospital, Airdrie ML6 0JS, UKScottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory (SHLMPRL), House on the Hill, Stobhill Hospital, 133 Balornock Road, Glasgow G21 3UW, UKScottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory (SHLMPRL), House on the Hill, Stobhill Hospital, 133 Balornock Road, Glasgow G21 3UW, UKA nonneutropenic patient with treated low-grade non-Hodgkin’s (Follicular) lymphoma and secondary hypogammaglobulinemia recovered from pneumococcal pneumonia and septicemia (serotype 7F; ST191) subsequent to influenza A H1N1 (2009). Both infections were potentially vaccine preventable. The patient then developed pneumococcal meningitis due to a serotype 35F pneumococcus with a unique Multilocus Sequence Type (ST7004) which was not vaccine preventable. Patient management was influenced by host predisposition to pneumococcal infection, antibiotic intolerance, and poor response to polysaccharide pneumococcal vaccine. Indirect immunofluorescence with anti-human immunoglobulin confirmed a poor or intermediate response to Pneumovax II. Prophylactic erythromycin was initiated, and immunoglobulin transfusions were also commenced as a preventive strategy. ST7004 is a single locus variant of ST1635 which has been associated with the serotype 35F capsule in England. The spi gene in ST7004, which differentiates it from ST1635, is the same as the spi gene present in ST191 which could have arisen from the first disease episode suggesting that horizontal gene transfer may have occurred between different populations of pneumococci present within the patient in an attempt to evade vaccination selection pressure.http://dx.doi.org/10.1155/2012/386372 |
| spellingShingle | Clare Murphy Donald Inverarity Claire McGoldrick Lindsay Mitchell Pamela Paterson Louise Thom Giles Edwards Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique Pneumococcus Case Reports in Hematology |
| title | Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique Pneumococcus |
| title_full | Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique Pneumococcus |
| title_fullStr | Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique Pneumococcus |
| title_full_unstemmed | Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique Pneumococcus |
| title_short | Treated Follicular Lymphoma, Recurrent Invasive Pneumococcal Disease, Nonresponsiveness to Vaccination, and a Unique Pneumococcus |
| title_sort | treated follicular lymphoma recurrent invasive pneumococcal disease nonresponsiveness to vaccination and a unique pneumococcus |
| url | http://dx.doi.org/10.1155/2012/386372 |
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