{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T06:26:03Z","timestamp":1746339963328},"reference-count":8,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2018,3,29]],"date-time":"2018-03-29T00:00:00Z","timestamp":1522281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>A 66 years old Caucasian woman with pneumococcal meningitis was treated and discharged after an uncomplicated course. Five months later she was readmitted withfever and right side abdominal pain and diagnosed with pneumococcal spondylodiscitis. One year later she was treated fora severe chest X-ray confirmed left lobar pneumonia. Two years later she was diagnosed with a pneumococcal pneumonia inher left lung with septic shock. An immunedeficiency screen revealed slightly reduced IgA levels, low IgG2 levels, low IgG3 levels and high IgG1 levels. No other immunedefects were identified. She did not respondserologically on vaccination with 13-valentconjugate and 23-valent polysaccharide pneumococcal vaccines. Further evaluations revealed a positive M-component inher blood and a bone marrow biopsy diagnosed her to have monoclonal gammopathy of undetermined significance. To protecther against future life threatening pneumococcal infections she was started on treatment with intravenous immunoglobulin. The case report illustrates the importance of thorough evaluation of patients with unusual infectious disease entities or unusual frequency of infections in individual patients. To optimize prophylactic measures and active treatment options in the individual patient, it is important to identify underlying causes of diseases and immune deficiencies that potentially can lead to life threatening infections. This is illustrated inour case by an undiagnosed monoclonal gammopathy of undetermined significancein an apparently healthy woman with atleast three life threatening documented pneumococcal infections in a two-year period and poor pneumococcal vaccine response<\/jats:p>","DOI":"10.4081\/idr.2018.7310","type":"journal-article","created":{"date-parts":[[2018,4,3]],"date-time":"2018-04-03T09:54:20Z","timestamp":1522749260000},"page":"7310","source":"Crossref","is-referenced-by-count":3,"title":["Meningitis, Spondylodiscitis, Pneumonia and Septic Shock with Streptococcus pneumoniae in a Previously Healthy Woman with Isolated IgG2-, IgG3-, IgA-Deficiency and Monoclonal Gammopathy of Undetermined Significance"],"prefix":"10.3390","volume":"10","author":[{"given":"Shahin","family":"Gaini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gudnason","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bjarni","family":"\u00e1 Steig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny J\u00f3nsd\u00f3ttir","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,3,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jim.2004.11.006","article-title":"Development and validation of a nonaplex assay for the simultaneous quantitation of antibodies to nine Streptococcus pneumoniae serotypes","volume":"296","author":"Lal","year":"2005","journal-title":"J Immunol Methods"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1186\/1471-2334-13-525","article-title":"Pneumococcal vertebral osteomyelitis at three teaching hospitals in Japan, 2003-2011: analysis of 14 cases and a review of the literature","volume":"13","author":"Suzuki","year":"2013","journal-title":"BMC Infect Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1212\/01.wnl.0000323929.02976.2b","article-title":"Vertebral osteomyelitis complicating pneumococcal meningitis","volume":"71","author":"Brouwer","year":"2008","journal-title":"Neurol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1086\/515194","article-title":"Streptococcus pneumoniae spinal infection in Nottingham, United Kingdom: not a rare event","volume":"28","author":"Turner","year":"1999","journal-title":"Clin Infect Dis"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S0140-6736(04)16727-5","article-title":"Osteomyelitis","volume":"364","author":"Lew","year":"2004","journal-title":"Lancet"},{"key":"ref6","first-page":"280","article-title":"Immunoglobulin G subclasses in immunodeficiency","volume":"19","author":"Soderstrom","year":"1987","journal-title":"Ann Clin Res"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1159\/000234258","article-title":"Immunoglobulin G subclass deficiencies","volume":"82","author":"Soderstrom","year":"1987","journal-title":"Int Arch Allergy Immunol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1128\/CVI.00021-11","article-title":"Comparative study of immune status to infectious agents in elderly patients with multiple myeloma, Waldenstrom's macroglobulinemia, and monoclonal gammopathy of undetermined significance","volume":"18","author":"Karlsson","year":"2011","journal-title":"Clin Vaccine Immunol"}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.pagepress.org\/journals\/index.php\/idr\/article\/viewFile\/7310\/7238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepress.org\/journals\/index.php\/idr\/article\/viewFile\/7310\/7301","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mdpi.com\/2036-7449\/10\/1\/7310\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T03:52:48Z","timestamp":1644465168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/10\/1\/7310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,29]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,3]]}},"alternative-id":["idr.2018.7310"],"URL":"https:\/\/doi.org\/10.4081\/idr.2018.7310","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,29]]}}}