A medical resident reported via a pharmacist that a child received a fourth dose of Prevnar and subsequently developed  "S. pneumoniae disease." Pneumococcal infection is considered medically important. Follow up information received from a medical resident on 11-JAN-2002 identified the child as female. The child was hospitalized in a pediatric intensive care unit with a diagnosis of sepsis and renal failure. A cerebrospinal fluid specimen was sent for serotyping. As of 11-JAN-2002, the child was intubated and was receiving peritoneal dialysis. No further information was available at the date of this report. Follow up information received from the medical resident on 1/26/02 indicated that the child received her fourth dose of Prevnar along with ActHIB, Tripedia, and IPV vaccines on 10/03/02 at 16 months ofage. The reporter noted that the cild was hospitalized with pneumococcal illness on 1/6/02. A blood culture revealed pneumococci. Diagnoses of pneumonia and hemolytic uremic syndrome were made. The child was evaluated for an immune disorder; results of quantitative immunoglobulin tests were as follows: IgG abnormal; IgM normal; IgA normal. Information regarding this event has been fowarded to manufacturer of the concomitantly administered vaccines. Follow up information received from the medical resident on 2/6/02 indicated that the pneumococcal isolate was identified as serotype 7F. As of 2/6/02, the child was nearly completely recovered; however, she had no renal function and continued on peritonal dialysis. Follow up information was received on 3/19/02. According to the reporter, the child presented to the hospital in respiratory failure following a progressive, febrile, respiratory illness of 5 days duration. She was immediately transported to the pediatric intensive care unit, where she was found to be oliguric, profoundly coagulopathic, and anemic. A chest x-ray showed a right middle lobe opacity. She was treated with blood products and IV antibiotics. At the time of her discharge, the child had completely reocvered with the exception of her renal status, remaining asuric and on peritoneal dialysis. The reporter noted that the child's medical history includes a brief hospitalization for a febrile respiratory illness at one year of age. Follow up information received from the medical resident on 9/20/02 indicated that the patient is well; however, she continues on peritoneal dialysis and is awaiting renal transplant. This case is being redistributed to reflect the correct company received date of 9/20/02. Follow up info was received on 3/19/02. According to the reporter, the child presented to the hospital in respiratory failure following a "progressive, febrile, respiratory illness" of 5 days duration. She was "immediately" transported to the pediatric intensive care unit, where she was found to be oliguric, "profoundly coagulopathic" and anemic. A chest x-ray showed a right middle lobe opacity. She was treated with blood products and IV antibiotics, and she was maintained on mechanical ventilation. She was discharged after 44 days. At the time of her discharge, the child "had completely recovered with the exception of her renal status, remaining anuric and on peritoneal dialysis." The reporter noted that the child's medical history includes a "brief" hospitalization for a febrile respiratory illness at one year of age. Follow up information received from the medical resident on 9/20/02 indicated that the patient is well; however, she continues on peritoneal dialysis and is awaiting renal transplant. This case is being redistributed to reflect the correct complany receive date of 9/20/02.