Pneumococcal infections generally occur sporadically.1 Household contacts of a patient with pneumococcal disease are considered to be at no risk of acquiring secondary infection. This is a report of two siblings who had invasive pneumococcal disease two days apart.
Report of Cases.—Case 1.—A 4-year-old black girl was admitted to an outlying hospital with a history of persistent fever for three days. On the day of admission she complained of a headache and had a brief generalized seizure. Physical examination on admission showed a lethargic, disoriented child. Her temperature was 40.3 °C; BP, 90/68 mm Hg; apical heart rate, 104 beats per minute; and respirations, 40/min. Her neck was stiff and her deep-tendon reflexes were depressed. Laboratory data disclosed a hemoglobin level of 9.8 mg/dL and a WBC count of 17,000/cu mm, with 29% polymorphonuclear leukocytes, 61% band forms, 8% lymphocytes, and 2% monocytes. Hemoglobin electrophoresis showed heterozygous