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

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.