Two cases of severe invasive infections in children caused by Streptococcus pneumoniae serotype 14--case report.

Two cases are presented of severe pneumococcal infections in infants caused by serotype 14 Streptococcus pneumoniae. The first case--meningitis--caused by S. pneumoniae (pneumococcus) with low-level penicillin susceptibility has developed from acute otitis media and resulted in fatal outcome. The second one--an immunocompromised child presenting recurrent otitis and chronic mastoiditis--developed into pneumococcal pneumonia. Both cases demonstrate the extreme importance of a relevant initial treatment of localized pneumococcal infections, preventing the development of generalized infection. Amoxicillin (an oral treatment option in both upper and lower respiratory tract infections caused also by Pneumococcus strains with low-level penicillin susceptibility due to its beneficial pharmacokinetics and pharmacodynamics) was not used in either case.