1.Serotype 15C Streptococcus pneumoniae with Third Cranial Nerve Palsy: Unusual Serotype and Presentation
Fatimahtuz Zahrah Muhamad Damanhuri ; Evelyn Aun ; Revathy Arushothy ; Thenmalar Kandasamy ; Adillahtul Bushro Zaini ; Siti Zulaikha Zakariah ; Siti Norbaya Masri
Malaysian Journal of Medicine and Health Sciences 2020;16(No.4):442-444
We present a unique case of pneumococcal meningitis caused by serotype 15C, a non-vaccine serotype, which is
long thought to be non-virulent. Our patient is a young lady with a known case of plaque psoriasis, presented with
sudden onset of left oculomotor nerve palsy and severe headache two days prior to admission. The clinical features
were initially mimicking of brain tumour and brain aneurysm. The diagnosis of pneumococcal meningitis was confirmed by the bacterial antigen test and genome detection using multiplex PCR from the CSF. The blood culture also
grew Streptococcus pneumoniae. Serotyping was performed on the isolate using Neufeld's Quellung method and it
was identified as serotype 15C. Psoriatic skin disease was identified as a potential source of this invasive infection.
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