An adult case of invasive pneumococcal disease due to serotype 12F-specific polysaccharide antibody failure following a 23-valent polysaccharide vaccination

Figures & data

Figure 1. Panel A. Supine anteroposterior chest radiograph on admission. An extensive consolidation is seen in the left lung. Panel B. Axial chest computed tomography image on admission. Multiple and diffuse low attenuation areas in bilateral lungs represent emphysema. Lobar consolidation is seen in the left upper lobe. Bronchial wall thickness and partial consolidation are seen in the left lower lobe. Panel C. Opsonophagocytic index (OI) and IgG of the patient’s serum for independent pneumococcal serotypes. A dotted line represents a cut-off OI of 8 (3). A grey line represents a cut-off of IgG of 0.2 μg/mL (5). Filled circles represent both PSV23- and PCV13-covered serotypes. Filled triangles represent only PSV23-covered serotypes. An open circle represents only the PCV13-covered serotype. Serotype 12F is the only serotype that was below the threshold in PSV23-covered serotypes. *An IgG against serotype 22F is missing due to the WHO-approved ELISA standard procedure (4).