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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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MENINGOCOCCAL SEROGROUP B SEPTIC SHOCK: VACCINE FAILURE

Luís Rodrigues1,2, João Farela Neves1, Flora Candeias1, Catarina Gouveia1, Maria João Simões3, Maria João Brito1

1- Infectious Diseases Unit, Hospital de Dona Estefânia Centro Hospitalar de Lisboa Central, Lisboa, Portugal
2- Serviço de Pediatria, Hospital do Espírito Santo de Évora, EPE, Évora, Portugal
3- Instituto Nacional de Saúde Dr. Ricardo Jorge, Portugal

- 35th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID). Madrid, 23 a 27 de Maio de 2017.
- Apresentação em poster e publicação sob a forma de resumo

Resumo:
Introduction: Invasive meningococcal disease (IMD) continues to be the most devastating infectious disease in childhood, affecting otherwise healthy, young individuals. Its incidence has been decreasing due to the use of vaccines against different serogroups. The 4 component vaccine against serogroup B is available since 2014.
Case presentation: A previously healthy 7-year-old boy that was adequately vaccinated against serogroup B Neisseria meningitidis was admitted in the Intensive Care Unit because of septic shock and meningitis. He received ceftriaxone and organ-support (cathecolamines and mechanical ventilation). His course was unremarkable and he was discharged after 15 days. Neisseria meningitidiswas identified in the blood culture, later confirmed to be serogroup B Neisseria meningitidis, belonging to the ST 41-44 clone. Vaccinated children should be protected against this clone, according to the Portuguese Meningococcal Antigen Typing System (MATS). Evaluation for an underlying immunodeficiency revealed that the patient was immunocompetent.
Comments:Serogroup B Neisseria meningitidis, belonging to the ST 41-44 clone is one of the the most frequently serogroup B meningococcal clones found in Portugal and responsible for IMD. The effectiveness of a vaccine is determined not only by the immunogenicity of its components, but especially by how widely it covers the disease, causing strains circulating in a given region and number of cases of vaccine failures. We present the first case of vaccine failure in Portugal.

Palavras Chave: Invasive meningococcal disease; Serogroup B Neisseria meningitidis; Vaccine failure