Streptococcus pneumoniae is one of the leading causes of pneumonia and several other invasive diseases as well as upper respiratory tract infections. They are more prevalent and serious in elderly and in those with chronic diseases and with high morbidity and mortality. Invasive pneumococcal diseases can most effectively be prevented by vaccination. The vaccine is effective and safe, even after revaccination. Nevertheless, some adverse events can occur, the most frequent being local, mild and self-limited. Although unusual, serious systemic reactions can eventually have a great impact in the individual health. The authors report a clinical case of a 66 years old man who was vaccinated with polyvalent polysaccharide pneumococcal vaccine and who developed a serious local and systemic reaction, including leukemoid reaction and respiratory insufficiency. In this respect they make some comments regarding the value of this vaccine.
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