First episode of invasive bacterial disease and its possible association with immune deficiency. Case series.

Abstract

Introduction: During the last decade, the epidemiology of severe invasive bacterial infections (SBI) in pediatrics has been drastically affected by the introduction of vaccines, so the need for admission to ICU is associated with pre-existing comorbidities or immunological deficiencies. Case report: Case 1: An 11-year-old female adolescent, who entered the emergency room with hypotensive tachycardic, pale, with decreased sounds in the left base and hypoactive, remained hospitalized for 9 days receiving teicoplanin and ceftriaxone meriting readmission and surgical drainage. Case 2: A 3-year-old male preschooler, consulted for fever and abdominal pain, went to the emergency room with signs of respiratory distress, abolished sounds in the left hemithorax and hypoactive. A pulmonary drainage of 300cc of sallow fluid was performed, receiving ceftriaxone and vancomycin, subsequently a chest CT showed a lung abscess. Case 3: 6-year-old male preschooler, assessed in the emergency room with respiratory distress and irritability with CT showing a pneumonic focus, receiving linezolid, complicated by septic arthritis requiring surgical cleaning. Discussion: This group of patients presented clinical pictures compatible with SBI, being previously healthy and immunized patients, this unusual behavior forces the pediatrician to think that there is an underlying cause, taking into account that the study of immunological alterations has not been standardized, and that the indication of specific tests should be individualized according to what we consider to be a humoral, cellular or complement deficiency, adapting the request for laboratories and the correct analysis of the hematology that offers essential information.