Invasive Pneumococcal Disease Presenting with Pyogenic Spondylitis in a Patient on Chronic Hemodialysis Who Previously Received a Pneumococcal Vaccine
Abstract
We herein report a case of cervical pyogenic spondylitis caused by Streptococcus pneumoniae in a woman on chronic hemodialysis who had received pneumococcal polysaccharide vaccine 23. The patient presented for routine hemodialysis with a fever but without focal signs. Blood cultures revealed S. pneumoniae (serotype 38, non-vaccine serotype type). Cervical magnetic resonance imaging showed C4-C5 marrow edema and endplate destruction. After brief empiric piperacillin-tazobactam, outpatient treatment comprising outpatient parenteral antimicrobial therapy with ceftriaxone was continued for six weeks, resulting in clinical resolution. Nonvaccine serotype invasive pneumococcal disease can cause spondylitis despite vaccination. Magnetic resonance imaging should be performed for similar patients to avoid neurological complications.
Related
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BibTeX
@article{arakawa2026invasive,
title = {{Invasive Pneumococcal Disease Presenting with Pyogenic Spondylitis in a Patient on Chronic Hemodialysis Who Previously Received a Pneumococcal Vaccine}},
author = {Mari Arakawa and Yoko Fujita and Yuki Yokokawa and Mariko Ito and Emiko Okuyama and Hirofumi Sumi and Naoto Tominaga},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.6747-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/18/65_6747-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Invasive Pneumococcal Disease Presenting with Pyogenic Spondylitis in a Patient on Chronic Hemodialysis Who Previously Received a Pneumococcal Vaccine
AU - Mari Arakawa
AU - Yoko Fujita
AU - Yuki Yokokawa
AU - Mariko Ito
AU - Emiko Okuyama
AU - Hirofumi Sumi
AU - Naoto Tominaga
PY - 2026
DA - 2026/09/15
JO - Internal Medicine
DO - 10.2169/internalmedicine.6747-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/18/65_6747-25/_article
AB - We herein report a case of cervical pyogenic spondylitis caused by Streptococcus pneumoniae in a woman on chronic hemodialysis who had received pneumococcal polysaccharide vaccine 23. The patient presented for routine hemodialysis with a fever but without focal signs. Blood cultures revealed S. pneumoniae (serotype 38, non-vaccine serotype type). Cervical magnetic resonance imaging showed C4-C5 marrow edema and endplate destruction. After brief empiric piperacillin-tazobactam, outpatient treatment comprising outpatient parenteral antimicrobial therapy with ceftriaxone was continued for six weeks, resulting in clinical resolution. Nonvaccine serotype invasive pneumococcal disease can cause spondylitis despite vaccination. Magnetic resonance imaging should be performed for similar patients to avoid neurological complications.
SN - 1349-7235
SN - 0918-2918
ER -