Recurrent Pneumococcal Bacteremia

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Abstract
RECURRENT pneumococcal bacteremia is an uncommon event. Although most reports1-4 in the literature are of isolated cases, recently some larger case series5-7 have been described. Episodes of recurrent pneumococcal bacteremia have been reported primarily in patients with underlying immunodeficiencies.1,2,4-7 The increased incidence of invasive pneumococcal disease in patients infected with human immunodeficiency virus (HIV) is well documented,8-16 but there are only limited references5-7,11,17-19 relating HIV infection and recurrent pneumococcal disease. Our medical center serves a community with one of the highest rates of HIV infection in the United States.20 In reviewing our overall experience with pneumococcal bacteremias during 5 years, we observed a higher rate of recurrence than that previously reported and a marked association between HIV infection and recurrences. We looked to determine what other variables besides HIV infection were associated with recurrent pneumococcal bacteremia and what effect recurrences had on mortality rates and on emergence of penicillin resistance.

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