Short communication, Note
Pneumococcal pancreatic pseudocyst
Maja Tomić-Paradžik
; Služba za mikrobiologiju, Zavod za javno zdravstvo Brodsko-posavske županije, Slavonski Brod, Hrvatska
Zvonko Mahovne
; Služba za unutarnje bolesti, Opća bolnica “Dr. Josip Benčević”, Slavonski Brod, Hrvatska
Abstract
Objective: Streptococcus pneumoniae is a respiratory pathogen which, beside upper
and lower respiratory system infections, can cause severe systemic infections, such as meningitis, endocarditis and sepsis, but also infections of the unusual areas – liver, pancreas,
muscle tissue and pelvis. This case illustrates a rarely documented complication of the chronic pancreatitis. Methods: This case illustrates a patient with long-time symptomatology,
demonstrating a non-specific abdominal pain with differential diagnosis of chronic pancreatitis,
with a pseudocyst detected radiologically (CT) and via ultrasound, following a drainage with ultrasound control. S. pneumoniae was isolated from the cyst in the pancreas head area. Results: Microbiological analysis showed a substantial number of pure culture of S. pneumoniae (106CFU/ml). After the drainage and antimicrobial therapy, patient did not show any of the previously described symptoms during control examinations, and remained in this condition all five years after the medical treatment. Discussion: Pseudocysts and pancreas
cysts are frequent complications of chronic pancreatitis, and there are many documented
cases of infection or colonization of the cyst formation. However, those are usually digestive system micro organisms, like gram-negative bacteria E. coli and K. pneumoniae, and mixed anaerobic-aerobic infections. These kind of unusual manifestations of pneumococcus
infections are today relatively rare, but still possible, due to the invasive abilities of this micro organism. Conclusion: The role of S. pneumoniae in the chronic pancreatitis complications
is not completely clear, and is very rarely documented in literature. It is necessary to analyse substantial number of samples taken by endoscopic or classical surgical methods to gain a clearer insight in the frequency of these infections.
Keywords
pancreas; pseudocyst; Streptococcus pneumoniae
Hrčak ID:
45859
URI
Publication date:
1.12.2009.
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