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Lack of efficacy: case report A 63-year-old woman exhibited lack of efficacy during treatment with ampicillin, ceftriaxon, vancomycin and unspecified catecholamines for Streptococcus pneumoniae sepsis. The woman with a history of type 2 diabetes mellitus presented to hospital with general malaise and vomiting for 4 hours. After further investigation, she was diagnosed with Streptococcus pneumoniae sepsis secondary to congenital asplenia. Two hours postarrival, she started receiving IV ceftriaxone 2 g/day, IV vancomycin 0.75g every 12 hours and IV ampicillin 2g every 6 hours. She also received unspecified catecholamine [catecholaminergic therapy]. She was then transferred to the ICU. Despite treatment with antibiotics and the unspecified catecholamine, her condition deteriorated. Within 24 hours of admission, she died of septic shock. Shibata J, et al. Pneumococcal infection transmission between family members with congenital asplenia: A case report. World Journal of Clinical Cases 7: 4277-4284, No. 24, 803499818 26 Dec 2019. Available from: URL: http://doi.org/10.12998/wjcc.v7.i24.4277

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