Two cases of pneumococcal spondylitis in the same household: a case report

BACKGROUND: Pneumococci normally reside in the nasopharynx, and when individuals are in close contact with each other such as in a community or a family setting, it is transmitted from carriers and sometimes results in pneumonia. CASE PRESENTATION: Case 1: The patient was a 55-year-old woman who visited the hospital complaining of fever and headache. Lumbar pain occurred on hospital day 2, and purulent spondylitis was diagnosed using lumbar MRI. Blood culture results were positive for pneumococcus. Case 2: The patient was a 60-year-old male, and the husband of the woman in the Case 1. Fever and lumbar pain occurred on the same day similar to Case 1. Inpatient treatment was provided for pneumococcal bacteremia. Although no abnormalities were observed on the lumbar MRI scan taken on hospital day 2, purulent spondylitis was diagnosed by an MRI taken on hospital day 9. Both patients received appropriate antimicrobial treatment. When bacterial strain analysis was performed on samples from Cases 1 and 2, we noted that the capsule serotype was 12F, the drug sensitivity was similar, and the sequence typing matched completely, indicating that the causative bacteria for both cases were identical. CONCLUSIONS: Pneumococcal bacteremia and purulent spondylitis can occur in different members of a family simultaneously. Pneumococcal infection can transmit between two close family members; hence, whenever a close family member of an individual who has already been infected with pneumococcal infection, develops fever, the possibility of transmission must be considered.