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Inicio Medicina Clínica (English Edition) Pneumococcal superinfection in COVID-19 patients: A series of 5 cases
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Vol. 155. Issue 11.
Pages 502-505 (December 2020)
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Vol. 155. Issue 11.
Pages 502-505 (December 2020)
Clinical report
DOI: 10.1016/j.medcle.2020.05.028
Pneumococcal superinfection in COVID-19 patients: A series of 5 cases
Sobreinfección por neumococo en pacientes con COVID-19: una serie de 5 casos
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David Cucchiaria, Juan M. Pericàsb,c, Josep Rierad, Roberto Gumucioe, Emmanuel Coloma Mdf,g,h, David Nicolásf,g,h,
Corresponding author
dnicolas@clinic.cat

Corresponding author.
, Hospital Clínic 4H Team
a Renal Transplantation Unit, Nephrology Service, Hospital Clinic Barcelona, Spain
b Infectious Disease Service, Hospital Clínic Barcelona, Spain
c Vall d’Hebron Institute for Research (VHIR), Barcelona, Spain
d Dermatology Service, Hospital Clinic Barcelona, Spain
e Rheumatology Service, Hospital Clinic Barcelona, Spain
f Hospital at Home Unit, Medical and Nurse Direction, Internal Medicine Service, Hospital Clinic Barcelona, Spain
g Universitat de Barcelona, Barcelona, Spain
h Institut d’Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Table 1. Clinical, laboratory and radiological characteristics of patients coinfected by SARS-2-CoV and Streptococcus pneumoniae.
Abstract
Background

In the context of the COVID-19 pandemic the risk of misdiagnosis of other causes of respiratory infection is likely. In this work we aim to describe the clinical characteristics, treatment and outcome of pneumococcal infection in COVID-19 patients.

Patients and methods

Every COVID-19 patient presenting with concomitant pneumococcal pneumonia during March 2020 in a tertiary teaching Hospital In Barcelona, Spain.

Results

Five patients with PCR confirmed COVID19 or clinical and radiological suspicion were diagnosed of pneumococcal infection. In all cases chest X-ray were abnormal, with unilateral or bilateral infiltrates. Procalcitonin showed to be not sensitive enough to detect pneumococcal infection. Antibiotherapy was promptly started in all five cases with subsequent satisfactory evolution.

Conclusion

International guidelines do not include the universal screening for bacterial co-infection. Radiological pattern of COVID-19 can be indistinguishable from that of pneumococcus pneumonia and frequency of co-infection is not well stablished, therefore clinicians should be aware of the possible SARS-CoV-2-pneumococcus association to avoid misdiagnosis and delay antibiotic therapy.

Keywords:
COVID-19
S. pneumoniae
co-infection
Diagnosis
Treatment
Resumen
Introducción

En el contexto de la pandemia por COVID-19 el riesgo de errores en el diagnóstico de otras causas de infección respiratoria es elevado. En este trabajo describimos las características clínicas, el tratamiento y la evolución de los pacientes con coinfección por COVID-19 y neumococo.

Pacientes y métodos

Todos los pacientes con COVID-19 que presentaron neumonía neumocócica durante marzo 2020 en un hospital universitario de Barcelona, España.

Resultados

Cinco pacientes con COVID-19 confirmada por PCR o sospecha radiológica fueron diagnosticados de infección por neumococo. En todos los casos la radiografía de tórax era patológica con infiltrado unilateral o bilateral. La procalcitonina demostró no ser suficientemente sensible para detectar la infección neumocócica. La antibioterapia fue iniciada de manera precoz en los 5 casos con evolución satisfactoria.

Conclusiones

Las guías internacionales no incluyen el cribado universal para coinfección bacteriana. El patrón radiológico del COVID-19 puede ser indistinguible de la neumonía neumocócica, y la frecuencia de la coinfección no ha sido establecida. Los clínicos deben de ser conscientes de la posible asociación de SARS-CoV-2 y neumococo para evitar errores diagnósticos y retrasos en el tratamiento antibiótico.

Palabras clave:
COVID-19
S. pneumoniae
Coinfección
Diagnóstico
Tratamiento

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