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Case Reports in Pediatrics
Volume 2013 (2013), Article ID 516746, 4 pages
http://dx.doi.org/10.1155/2013/516746
Case Report

Pneumococcal Meningitis in an Adolescent with Fever and Foot Ache

1Paediatrics Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Unidade II, 4400-129 Vila Nova de Gaia, Portugal
2Orthopaedics Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Unidade II, 4400-129 Vila Nova de Gaia, Portugal

Received 12 June 2013; Accepted 2 July 2013

Academic Editors: S. M. Dehghani, W. B. Moskowitz, and Y.-H. Weng

Copyright © 2013 Catarina Dias 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.

Abstract

Invasive pneumococcal disease predominantly affects younger children, elderly, and immunocompromised patients. Pneumococcal meningitis is a particularly important form of presentation, considering its high rate of morbimortality. We present the case of a previously healthy 12-year-old adolescent male who was hospitalized due to suspicion of osteoarticular infection in his left foot. A few hours later, he developed meningeal signs, exhibiting slight pleocytosis and Streptococcus pneumoniae isolates in both cerebrospinal fluid and blood. Imaging studies were inconclusive regarding the nature of the foot disorder. We considered the hypothesis of osteomyelitis of the navicular bone as the most likely, for which he completed six weeks of antibiotic therapy. There was a favorable clinical evolution, along with complete absence of osteoarticular or neurological sequelae. The relevance of this clinical case resides in the unusual presentation of invasive pneumococcal disease in this age group, as well as in the rare form of orthopedic involvement.