# Severe Invasive Pneumococcal Infection With Multiple Abscesses Caused by a Less Virulent Serotype 1 Pneumococcus: A Case Report

## TL;DR

A 68-year-old man suffered a severe invasive pneumococcal infection with multiple abscesses caused by a less virulent pneumococcus serotype 1, emphasizing the importance of vaccination.

## Contribution

This case report highlights the rare severity of serotype 1 pneumococcal infection and underscores the importance of pneumococcal vaccination.

## Key findings

- Serotype 1 pneumococcus caused severe invasive disease with multiple abscesses in an older adult.
- The patient's prolonged hospitalization suggests the infection could have been prevented with pneumococcal vaccination.
- Serotype 1 is typically less virulent, making this case an unusual and important clinical observation.

## Abstract

Invasive pneumococcal disease (IPD) has a high fatality rate; however, its severity varies by pneumococcal serotype. Serotype 1 pneumococcus is often associated with empyema but typically has a low fatality rate, and IPD is rarely reported in such cases. We report the case of a 68-year-old man who developed IPD with systemic abscesses, including empyema, purulent pericardial effusion, and an intramuscular abscess in the right thigh, along with sepsis caused by serotype 1 pneumococcus. He remained hospitalized for 10 months. This level of disease severity may have been preventable if the patient had obtained serotype 1 immunity through the pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23). This case highlights the critical importance of pneumococcal vaccination for older adults and immunocompromised individuals.