RESUMO
El papel de Streptococcus pneumoniae como agente causal de infecciones de piel y tejidos blandos (IPTB) es inusual y de difícil interpretación clínica. Describimos 3 casos documentados (años 2010, 2011 y 2015) en pacientes internados en el Hospital Provincial de Pediatría de Misiones, detectados durante 10 años de vigilancia de enfermedades invasivas (EI). Estos casos correspondieron a 2 niñas de 8 y 7 meses y a un varón de 2 años con diagnóstico de absceso glúteo, celulitis preseptal y piodermitis, respectivamente. Todos eran eutróficos, con buen estado general al ingreso, uno de ellos seropositivo para virus de la inmunodeficiencia humana. Los aislamientos presentaron características de sensibilidad a antimicrobianos y serotipos que se enmarcaron dentro de la epidemiología local de las EI neumocócicas. A pesar de la baja frecuencia, la etiología de S. pneumoniae en IPTB debe considerarse. Nuestros hallazgos revalorizan el papel del laboratorio en el diagnóstico por cultivo y contribuyen a documentar el comportamiento de este patógeno.
The role of Streptococcus pneumoniae as a causative agent of skin and soft tissue infections (SSTI) is unusual and its clinical interpretation is difficult. We describe here three cases of SSTI due to S. pneumoniae in patients admitted to the Provincial Pediatric Hospital of Misiones, Argentina that were detected during 10 years of invasive disease (ID) surveillance documented in 2010, 2011 and 2015. These cases involved two girls aged 8 and 7 months old, and a two-year-old male child with diagnoses of gluteal abscess, preseptal cellulites and pyoderma respectively. All the patients were eutrophic and in good general condition on admission; one of them was seropositive for HIV. Antimicrobial susceptibility and serotypes were framed within the local epidemiology of invasive pneumococcal disease. Despite its low frequency, S. pneumoniae as an etiological agent of SSTI must be considered. Our findings revalue the role of the diagnostic laboratory and contribute to document the behavior of this pathogen.