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Case Reports in Medicine
Volume 2012, Article ID 310104, 4 pages
Case Report

Megapneumonia Coinfection: pneumococcus, Mycoplasma pneumoniae, and Metapneumovirus

1Department of Paediatrics, The Chinese University of Hong Kong, 6/F Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
2Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
3Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

Received 25 July 2012; Revised 25 September 2012; Accepted 25 September 2012

Academic Editor: Frans J. Walther

Copyright © 2012 Kam Lun Hon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report a young girl who died of Streptococcus pneumoniae 19A pneumonia, septic shock, and hemolytic uremic syndrome despite prior pneumococcal vaccination, appropriate antibiotics, and aggressive intensive care support. Serotype 19A is not covered by the 7- or 10-valent pneumococcal vaccines. Mycoplasma pneumoniae and metapneumovirus were simultaneously detected by PCR in the nasopharyngeal and tracheal aspirates. The pneumococcus is penicillin sensitive. Although infections with each of these pathogens alone are typically mild, this case highlights that co-infection with the triple respiratory pathogens possibly contributed to the fatal outcome of this child. Also, the new policy in Hong Kong to use PCV13 may help prevent further cases of serotype 19A infections.