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BMJ Case Rep ; 20122012 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-22604203

RESUMEN

An elderly lady was admitted for pain management and rehabilitation following a fall. During her stay she developed a new heart murmur and sepsis. Subacute bacterial endocarditits was excluded, empirical ciprofloxacin was initiated and later converted to aztreonam with gentamicin for clinical deterioration. Subsequent investigations revealed meningococcal Y septicaemia secondary to pneumonia, with a possible oropharynx focus. Upon discharge she had returned to baseline state. The case reflects an unusual and increasing cause of pneumonia. A steady increase of infective serogroup Y isolates over the past 12-years in England, with tendency towards elderly makes it a significant differential among the general medical population. This trend corresponds with the US, but is yet unknown whether to be a periodic cycle or true change in dominance and, or, virulence among serogroups. If the latter were true, it would support the inclusion of serogroups beyond menigitides C in the vaccination program.


Asunto(s)
Accidentes por Caídas , Infecciones Meningocócicas/diagnóstico , Neumonía Bacteriana/diagnóstico , Neumonía Bacteriana/microbiología , Sepsis/diagnóstico , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Diagnóstico por Imagen , Femenino , Humanos , Infecciones Meningocócicas/tratamiento farmacológico , Vacunas Meningococicas , Neumonía Bacteriana/tratamiento farmacológico , Sepsis/tratamiento farmacológico , Serotipificación
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